Individual
DR. HAMID JACK MOALLEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
450 CLARKSON AVE, B4-333, BROOKLYN, NY 11203-2056
(718) 270-4714
(718) 270-1985
Mailing address
450 CLARKSON AVE, BOX 1262, BROOKLYN, NY 11203-2056
(718) 270-8867
(718) 270-1794
Taxonomy
Speciality
Code
Description
License number
State
2080P0201X
Pediatric Allergy/Immunology Physician
Primary
183019-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01422884
—
NY
Enumeration date
12/08/2005
Last updated
02/27/2013
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