Provider Demographics
NPI:1497040547
Name:CHAFFER, JACQUELINE A (DVM)
Entity type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:A
Last Name:CHAFFER
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 AIRPORT PLAZA BLVD
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-3934
Mailing Address - Country:US
Mailing Address - Phone:631-843-9009
Mailing Address - Fax:631-843-9119
Practice Address - Street 1:241 AIRPORT PLAZA BLVD
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-3934
Practice Address - Country:US
Practice Address - Phone:631-843-9009
Practice Address - Fax:631-843-9119
Is Sole Proprietor?:No
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011036174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian