Provider Demographics
NPI:1669563938
Name:BAFFA, JEANNE MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:JEANNE
Middle Name:MARIE
Last Name:BAFFA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 191
Mailing Address - Street 2:PROVIDER ENROLLMENT DEPT
Mailing Address - City:ROCKLAND
Mailing Address - State:DE
Mailing Address - Zip Code:19732-0191
Mailing Address - Country:US
Mailing Address - Phone:302-651-6212
Mailing Address - Fax:302-651-4945
Practice Address - Street 1:A.I. DUPONT HOSPITAL FOR CHILDREN
Practice Address - Street 2:1600 ROCKLAND ROAD
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3607
Practice Address - Country:US
Practice Address - Phone:302-651-4000
Practice Address - Fax:302-651-4945
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2011-09-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DEC100052402080P0202X
MDD00433392080P0202X
NJMA068772002080P0202X
PAMD038107E2080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID806322600Medicaid
TXP8B200780Medicaid
MD0543519Medicaid
IA0509943Medicaid
NY01289629Medicaid
PA001272391Medicaid
NJ5077001Medicaid
SCQ05240Medicaid
NJ5077001Medicaid
TXP8B200780Medicaid
710513SAJMedicare PIN