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Individual

FERN BLUMENFELD-JAFFE

Active
Sole proprietor

Provider details

NPI number
Gender
F

Contact information

Practice address
64 BLACK ROCK AVE, BRIDGEPORT, CT 06605-1200
(203) 337-5174
(203) 337-5177
Mailing address
471 BARNUM AVE, BRIDGEPORT, CT 06608-2409
(203) 333-6864
(203) 332-0376

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
000045
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000045
STATE LICENSE
CT
Enumeration date
11/23/2005
Last updated
07/08/2007
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