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Individual

MICHAEL JAFFE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
PO BOX 467, ZUNI, NM 87327-0467
(505) 782-4431
(505) 782-7405
Mailing address
201 PINNACLE DRIVE, APT. 3622, RIO RANCHO, NM 87124-0997
(505) 358-8798

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
PHA0021706
CO
183500000X
Pharmacist
Primary
RP00008075
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PHA0021706
COLORADO BOARD OF PHARMACY
CO
01
RP00008075
NEW MEXICO BOARD OF PHARMACY
NM
Enumeration date
07/17/2016
Last updated
01/29/2018
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