Basic Information
| Provider Information | |||||||||
| NPI: | 1164149001 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HAMZA JALAL DO PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 35 BIRCHWOOD DR | ||||||||
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| City: | HUNTINGTON STATION | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117463924 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 15817 97TH ST | ||||||||
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| City: | HOWARD BEACH | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114143228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7188455252 | ||||||||
| FaxNumber: | 7188456464 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/21/2022 | ||||||||
| LastUpdateDate: | 10/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | JALAL | ||||||||
| AuthorizedOfficialFirstName: | HAMZA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6315729139 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 10/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.