Dr. Mark H. Jaffe

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

License

10797 Issued in NJ

Legal business name

DR. MARK H. JAFFE

Practice address

375 S Washington Ave
Bergenfield, NJ 07621-4323

Phone

(201) 385-0775

Fax

(201) 385-5375

NPI assigned

May 8, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mark Harris Jaffe

Title

Director

Phone

(201) 385-0775

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323129600000",
    "number": "1396958724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 S WASHINGTON AVE",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076214323",
            "telephone_number": "201-385-0775",
            "fax_number": "201-385-5375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 S WASHINGTON AVE",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076214323",
            "telephone_number": "201-385-0775",
            "fax_number": "201-385-5375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MARK H. JAFFE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2011-12-06",
        "status": "A",
        "authorized_official_last_name": "JAFFE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "HARRIS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "201-385-0775"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "NJ",
            "license": "10797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.

Verify at the official NPI Registry.