Provider Demographics
NPI:1699715490
Name:JAFRI, SAIMA N (DO)
Entity type:Individual
Prefix:
First Name:SAIMA
Middle Name:N
Last Name:JAFRI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 KENSINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06051-3916
Mailing Address - Country:US
Mailing Address - Phone:860-348-4878
Mailing Address - Fax:860-348-4876
Practice Address - Street 1:18 CEDAR ST
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-2647
Practice Address - Country:US
Practice Address - Phone:860-666-5167
Practice Address - Fax:860-666-5153
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT041150208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1255448155OtherGHMC GRP NPI ID
CT041150OtherCONNECTICARE
CT2V7192OtherHEALTH NET PROV ID
CT001411503Medicaid
CT004195930Medicaid
CT040041150CT02OtherBCBS N BCFP PROV ID
CT271383OtherWELLCARE MEDICARE
CT2727699OtherCIGNA PROV ID
CTP3644959OtherOXFORD PROV ID
CT271383OtherWELLCARE MEDICARE
CT1255448155OtherGHMC GRP NPI ID
CTI49472Medicare UPIN