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General NPI Number Information
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NPI Number | 1023523198
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Entity Type | Organization
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Legal Business Name | RANDA JAAFAR MD,PC
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Dates
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Enumeration Date | 12/11/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 340 EAST 49TH ST. GROUND FLOOR
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City | NEW YORK
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State | NY
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Zip | 10017
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Country | US
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Telephone | 646-876-5566
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Fax | 646-876-5577
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Provider Business Mailing Address
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Address Line | 250 49TH ST 17A
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City | NEW YORK
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State | NY
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Zip | 10017
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Country | US
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Telephone | 646-876-5566
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Fax | 646-876-5577
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Authorized Official
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Title or Position | OWNER
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Name | RANDA JAAFAR
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Credential | MD
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Telephone | 646-876-5566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 261144
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License Number State | NY
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