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General NPI Number Information
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NPI Number | 1588358683
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Entity Type | Individual
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Provider Name | HASSAN KHOJASTEH JAFARI MD
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Gender | Male
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Dates
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Enumeration Date | 06/05/2023
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 300 STATE ST STE 201
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City | ERIE
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State | PA
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Zip | 16507-1429
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Country | US
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Telephone | 305-326-6391
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Fax |
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Provider Business Mailing Address
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Address Line | 5845 BLUESTONE DR
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City | FAIRVIEW
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State | PA
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Zip | 16415-2545
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Country | US
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Telephone | 65-078-9176
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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 | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | MD489419
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License Number State | PA
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