Provider Demographics
NPI:1962713511
Name:JAFFE, REBECCA NECHAMA
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:NECHAMA
Last Name:JAFFE
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:RIVKA
Other - Middle Name:NECHAMA
Other - Last Name:JAFFE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR
Mailing Address - Street 1:16 PRICE DR
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-3015
Mailing Address - Country:US
Mailing Address - Phone:732-572-7796
Mailing Address - Fax:
Practice Address - Street 1:16 PRICE DR
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-3015
Practice Address - Country:US
Practice Address - Phone:732-572-7796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016153-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist