MEDICARE: RASHEED U JAFAR MDPC

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	174400000X	Specialist	122644	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821227075
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RASHEED U JAFAR MDPC

Provider Business Mailing Address
First Line	:	1510 GRAND AVE
Second Line	:
City	:	NORTH BALDWIN
State	:	NY
Zip	:	11510-1943
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1510 GRAND AVE
Second Line	:
City	:	NORTH BALDWIN
State	:	NY
Zip	:	11510-1943
Country	:	US
Telephone Number	:	516-223-3804
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	LISA AUSTIN
Credential	:	COORDINATOR
Telephone Number	:	516-223-3804

Provider Enumeration Date	:	07/09/2009
Last Update Date	:	08/04/2009

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