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General NPI Number Information
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NPI Number | 1023289378
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Entity Type | Individual
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Provider Name | JONATHAN DOUGLAS JAFFE D.O.
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Gender | Male
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Dates
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Enumeration Date | 03/14/2008
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 175 MADISON AVE FL 1
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City | MOUNT HOLLY
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State | NJ
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Zip | 08060-2099
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Country | US
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Telephone | 609-914-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 301 LIPPINCOTT DR STE 410
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City | MARLTON
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State | NJ
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Zip | 08053-4197
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Country | US
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Telephone | 856-355-0340
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 2010-01825
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 2010-01825
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 25MB12389900
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License Number State | NJ
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