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Individual

MORTAZA JAFARI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
176 BLOOMFIELD AVE, NEWARK, NJ 07104-1127
(973) 484-7702
Mailing address
176 BLOOMFIELD AVE, NEWARK, NJ 07104-1127
(973) 484-7702

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA07476500
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1758705
NJ
Enumeration date
11/01/2006
Last updated
07/08/2007
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