Provider Demographics
NPI:1932992393
Name:JAFAROVA, ULKAR
Entity type:Individual
Prefix:
First Name:ULKAR
Middle Name:
Last Name:JAFAROVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 LONGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-3006
Mailing Address - Country:US
Mailing Address - Phone:949-346-7971
Mailing Address - Fax:
Practice Address - Street 1:22901 MILLCREEK BLVD STE 200
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5701
Practice Address - Country:US
Practice Address - Phone:216-377-6050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRES.OO4926390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program