Healthcare Provider Details

I. General information

NPI: 1376625202
Provider Name (Legal Business Name): RINA JAFFE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 04/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3227 LONG BEACH RD SUITE 1
OCEANSIDE NY
11572-3651
US

IV. Provider business mailing address

68 S SERVICE RD SUITE 350
MELVILLE NY
11747-2354
US

V. Phone/Fax

Practice location:
  • Phone: 516-897-5000
  • Fax: 516-431-7519
Mailing address:
  • Phone: 516-945-3000
  • Fax: 516-945-3131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number218740
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: