Jaffe, Mark Lawrence
Jaffe, Mark Lawrence is an individual health care provider with primary practice located at 6666 W Peoria Ave Ste 109, Glendale AZ 85302-7032. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Jaffe, Mark Lawrence can be contacted via phone (623) 979-8876.Contact Information
Primary practice address
6666 W Peoria Ave Ste 109
Glendale AZ 85302-7032
Phone: (623) 979-8876
Fax: (623) 979-2811
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 114 | Arizona |
Profile Details
| NPI number | 1093717373 |
|---|---|
| LBN Legal business name | Jaffe, Mark Lawrence |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 1st, 2005 |
| Last updated | Jan 2nd, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093717373 | NPPES |
| Arizona | Other | P00360908 | RAIL ROAD MEDICARE |
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