Active NPI
Judith Liza Jaffe, M.D.
- Pediatrics Physician
- New York, NY
National Provider Identifier
1053697581
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 131769
- Practice address
- 413 E 120TH St
Nyc Dept of School Health
New York, NY 10035-3602 - Phone
- (917) 492-6950
- Fax
- (917) 492-6972
- NPI assigned
- Oct 28, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 131769 | NY | Primary |
Addresses
Primary practice location
413 E 120TH St
Nyc Dept of School Health
New York, NY 10035-3602
Mailing address
413 East 120TH Street
Nyc Dept of School Health
New York, NY 10035-3602
Phone (917) 492-6950
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 131769 | NY | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319760000000",
"number": "1053697581",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "413 EAST 120TH STREET",
"address_2": "NYC DEPT OF SCHOOL HEALTH",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100353602",
"telephone_number": "917-492-6950",
"fax_number": "917-492-6972"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "413 E 120TH ST",
"address_2": "NYC DEPT OF SCHOOL HEALTH",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100353602",
"telephone_number": "917-492-6950",
"fax_number": "917-492-6972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAFFE",
"first_name": "JUDITH",
"middle_name": "LIZA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-28",
"last_updated": "2011-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "131769",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.