Healthcare Provider Details

I. General information

NPI: 1730139304
Provider Name (Legal Business Name): NASIMA NEELOFER JAFFERY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 WILLIAMSPORT CIR
SALISBURY MD
21804-6400
US

IV. Provider business mailing address

102 WILLIAMSPORT CIR
SALISBURY MD
21804-6400
US

V. Phone/Fax

Practice location:
  • Phone: 443-978-7028
  • Fax: 443-944-9023
Mailing address:
  • Phone: 443-978-7028
  • Fax: 443-944-9023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberD0064352
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberD0064352
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: