Provider Demographics
NPI:1588861447
Name:DR. JOEL H. JAFFE PC
Entity type:Organization
Organization Name:DR. JOEL H. JAFFE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:H
Authorized Official - Last Name:JAFFE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:215-928-0194
Mailing Address - Street 1:711 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19123-2737
Mailing Address - Country:US
Mailing Address - Phone:215-928-0194
Mailing Address - Fax:215-928-1147
Practice Address - Street 1:711 N 7TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19123-2737
Practice Address - Country:US
Practice Address - Phone:215-928-0194
Practice Address - Fax:215-928-1147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS002930L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty