Basic Information
Provider Information
NPI: 1376625202
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JAFFE
FirstName: RINA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
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Mailing Information
Address1: 68 S SERVICE RD
Address2: SUITE 350
City: MELVILLE
State: NY
PostalCode: 117472354
CountryCode: US
TelephoneNumber: 5169453000
FaxNumber: 5169453131
Practice Location
Address1: 3227 LONG BEACH RD
Address2: SUITE 1
City: OCEANSIDE
State: NY
PostalCode: 115723651
CountryCode: US
TelephoneNumber: 5168975000
FaxNumber: 5164317519
Other Information
ProviderEnumerationDate: 10/19/2006
LastUpdateDate: 04/18/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X218740NYY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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