MEDICARE: BRADLEY JAFFE LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	092406	NY
2	1041C0700X	Clinical Social Worker	ISW10684	FL

General Provider Information

NPI Number	:	1558770057
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRADLEY JAFFE LMSW

Provider Business Mailing Address
First Line	:	5410 EAST AVE
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-2344
Country	:	US
Telephone Number	:	561-213-0361
Fax Number	:

Provider Business Practice Location Address
First Line	:	5410 EAST AVENUE
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-2344
Country	:	US
Telephone Number	:	561-213-0361
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2014
Last Update Date	:	09/30/2016

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Directions to “ BRADLEY JAFFE LMSW” Practice Location

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