Healthcare Provider Details

I. General information

NPI: 1760908503
Provider Name (Legal Business Name): JEFFREY ARTHUR NAFASH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2017
Last Update Date: 07/03/2024
Certification Date: 07/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 E 210TH ST FL SE1
BRONX NY
10467-2401
US

IV. Provider business mailing address

3415 BAINBRIDGE AVENUE ROSENTHAL SE
BRONX NY
10467
US

V. Phone/Fax

Practice location:
  • Phone: 718-741-2343
  • Fax: 718-920-4351
Mailing address:
  • Phone: 718-741-2343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number300334
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number300334
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: