Healthcare Provider Details

I. General information

NPI: 1740922954
Provider Name (Legal Business Name): NADIM JAAFAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2022
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N ACADEMY AVE
DANVILLE PA
17822-0001
US

IV. Provider business mailing address

100 N ACADEMY AVE
DANVILLE PA
17822-0001
US

V. Phone/Fax

Practice location:
  • Phone: 570-271-6523
  • Fax: 570-271-8795
Mailing address:
  • Phone: 570-271-6523
  • Fax: 570-271-8795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMT236528
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: