Healthcare Provider Details

I. General information

NPI: 1235593658
Provider Name (Legal Business Name): JAFREEN SADEQUE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2016
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 W BETHANY HOME RD STE 200
PHOENIX AZ
85015-2443
US

IV. Provider business mailing address

2000 W BETHANY HOME RD STE 200
PHOENIX AZ
85015-2443
US

V. Phone/Fax

Practice location:
  • Phone: 480-462-5519
  • Fax: 602-347-5402
Mailing address:
  • Phone: 480-462-5519
  • Fax: 602-347-5402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number76767
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: