Provider Demographics
NPI:1588358683
Name:KHOJASTEH JAFARI, HASSAN (MD)
Entity type:Individual
Prefix:
First Name:HASSAN
Middle Name:
Last Name:KHOJASTEH JAFARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5845 BLUESTONE DR
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:PA
Mailing Address - Zip Code:16415-2545
Mailing Address - Country:US
Mailing Address - Phone:065-078-9176
Mailing Address - Fax:
Practice Address - Street 1:300 STATE ST STE 201
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-1429
Practice Address - Country:US
Practice Address - Phone:305-326-6391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-05
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD489419207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist