Healthcare Provider Details

I. General information

NPI: 1467616094
Provider Name (Legal Business Name): JAFAR KAFAIE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2008
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 FROM RD STE 506
PARAMUS NJ
07652-3517
US

IV. Provider business mailing address

1008 S SPRING AVE
SAINT LOUIS MO
63110-2520
US

V. Phone/Fax

Practice location:
  • Phone: 551-996-8100
  • Fax: 551-996-4140
Mailing address:
  • Phone: 314-977-4866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License Number25MA12773400
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number25MA12773400
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number2009010071
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: