Basic Information
| Provider Information | |||||||||
| NPI: | 1144674847 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JALEEL | ||||||||
| FirstName: | SABAHATH | ||||||||
| MiddleName: | HUMA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1566 MEDICAL DR STE 104 | ||||||||
| Address2: | |||||||||
| City: | POTTSTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194643229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4849450075 | ||||||||
| FaxNumber: | 4849457650 | ||||||||
| Practice Location | |||||||||
| Address1: | 1566 MEDICAL DR STE 104 | ||||||||
| Address2: | |||||||||
| City: | POTTSTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194643229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4849450075 | ||||||||
| FaxNumber: | 4849450781 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/19/2016 | ||||||||
| LastUpdateDate: | 11/19/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | MD475746 | PA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | 208M00000X | 25MA10391800 | NJ | N | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.