Kenneth Robert Jaffe, D.V.M.
Individual provider Active NPI Veterinarian · Andover, NJ
NPI 1861664708 · NPPES record last updated Apr 1, 2008
Key facts
- NPI
- 1861664708
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Veterinarian 174M00000X
- License
- 29VI00151500 (NJ)
- Practice address
- 27 Lenape Ave
Andover, NJ 07821-1082 - Phone
- (973) 786-6991
- Fax
- (973) 786-6991
- NPI assigned
- Apr 1, 2008
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29VI00151500 | NJ | MD | Veterinarian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Veterinarian | 174M00000X | 29VI00151500 | NJ | Yes |
Addresses
Primary practice location
27 Lenape Ave
Andover, NJ 07821-1082
Mailing address
P.O.Box 1082
27 Lenape Ave
Andover, NJ 07821-1082
Phone (973) 786-6991
Other providers in Andover, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 1, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.