Provider Demographics
NPI:1053895441
Name:JAAFAR, HUSSEIN
Entity type:Individual
Prefix:
First Name:HUSSEIN
Middle Name:
Last Name:JAAFAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:266 HARRISTOWN RD STE 200
Mailing Address - Street 2:
Mailing Address - City:GLEN ROCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07452-3354
Mailing Address - Country:US
Mailing Address - Phone:201-445-7000
Mailing Address - Fax:
Practice Address - Street 1:4700 BERGENLINE AVE
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-1610
Practice Address - Country:US
Practice Address - Phone:201-730-6513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-20
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048371225100000X
NJ40QA01822700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist