Provider Demographics
NPI:1053697581
Name:JAFFE, JUDITH LIZA (MD)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:LIZA
Last Name:JAFFE
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Gender:F
Credentials:MD
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Mailing Address - Street 1:413 EAST 120TH STREET
Mailing Address - Street 2:NYC DEPT OF SCHOOL HEALTH
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-3602
Mailing Address - Country:US
Mailing Address - Phone:917-492-6950
Mailing Address - Fax:917-492-6972
Practice Address - Street 1:413 E 120TH ST
Practice Address - Street 2:NYC DEPT OF SCHOOL HEALTH
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-3602
Practice Address - Country:US
Practice Address - Phone:917-492-6950
Practice Address - Fax:917-492-6972
Is Sole Proprietor?:No
Enumeration Date:2011-10-28
Last Update Date:2011-10-28
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Provider Licenses
StateLicense IDTaxonomies
NY131769208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics