Individual
DR. ADAM DAVID JAFFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
123 MAIN ST, CANTON, NY 13617-0310
(315) 386-8811
Mailing address
123 MAIN ST, POB 310, CANTON, NY 13617-0310
(315) 386-8811
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV04631
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0304570001
MEDICARE DME SUPPLIER
NY
Enumeration date
07/12/2006
Last updated
07/08/2007
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