Mark Lawrence Jaffe O.D.

NPI 1093717373 - Optometrist - 152W00000X

NPI Details
NPI 1093717373
Gender Male
Enumeration Date 06/01/2005
Last Updated 01/02/2008
Entity Type Individual
Active Over 11 years ago
Practice Location
6666 W PEORIA AVE
STE 109
GLENDALE AZ, 85302-7032, US
Phone (623) 979-8876
Fax (623) 979-2811
Business Location
6404 W WETHERSFIELD RD
GLENDALE AZ, 85304-1630, US
Phone (623) 878-8538
Fax (623) 878-8538
Toxanomy
Taxonomy Code 152W00000X
License State Arizona
License Number 114
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According to our database, Dr. Mark Lawrence Jaffe O.D. NPI is 1093717373, taxonomy code is 152W00000X and license number is 114, license state is located at Arizona. Mark Lawrence Jaffe O.D. physically located at 6666 W Peoria Ave, Glendale AZ, 85302-7032. NPI Number Mark Lawrence Jaffe O.D. has the Individual type.

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1093717373 NPI number is provided on an as is basis without warranty of any kind. 1093717373 is maintained by the National Plan & Provider Enumeration System. The contents of Mark Lawrence Jaffe O.D. are for informational purposes only.