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Organization
787 MEDICAL PC
Active
Organization
787 MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUHAMMAD JALALUDDIN MD (DIRECTOR)
(210) 268-5398
Entity
Organization
Contact information
Practice address
235 FOREST AVE, GLEN COVE, NY 11542-2034
(718) 285-7023
(516) 671-6372
Mailing address
217 OLD ITHACA RD, HORSEHEADS, NY 14845-1778
(607) 731-4644
Taxonomy
Speciality
Code
Description
License number
State
163WP0000X
Pain Management Registered Nurse
—
—
202D00000X
Integrative Medicine Physician
Primary
—
—
202K00000X
Phlebology Physician
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
207QB0002X
Obesity Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
05/24/2025
Last updated
04/01/2026
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