# ABDUR R JALAZAI MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386748416
- **Authorized official:** MR. ABDUR R JALALZAI MD (OWNER PRESIDENT SECRETARY)
- **Authorized official phone:** (315) 535-9229

## Contact information

- **Practice address:** 63 WEST BARNEY ST, GOUVERNEUR, NY 13642
- **Practice address phone:** (315) 287-1770
- **Practice address fax:** (315) 287-1170
- **Mailing address:** 63 WEST BARNEY ST, GOUVERNEUR, NY 13642
- **Mailing address phone:** (315) 287-1770
- **Mailing address fax:** (315) 287-1170

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 126123 | NY | Yes |

## Other

- **Enumeration date:** 09/11/2006
- **Last updated:** 08/22/2020