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General NPI Number Information
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NPI Number | 1316504178
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Entity Type | Individual
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Provider Name | RYAN JAFRI LMSW
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Gender | Male
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Dates
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Enumeration Date | 05/28/2019
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Last Update Date | 05/20/2020
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Provider Practice Location Address
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Address Line | 15 NEW HOLLAND VLG
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City | NANUET
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State | NY
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Zip | 10954-2436
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Country | US
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Telephone | 845-596-6503
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Fax |
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Provider Business Mailing Address
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Address Line | 580 WHITE PLAINS RD STE 510
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City | TARRYTOWN
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State | NY
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Zip | 10591-5152
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Country | US
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Telephone | 914-345-5900
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 102277-1
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License Number State | NY
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