Individual
MR. MANOUCHER JALALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2211 CHICHESTER AVE, SUITE 102, BOOTHWYN, PA 19061
(610) 494-3911
(610) 497-5047
Mailing address
2211 CHICHESTER AVE, SUITE 102, BOOTHWYN, PA 19061
(610) 494-3911
(610) 497-5047
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD036214L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007580360002
—
PA
Enumeration date
07/07/2006
Last updated
07/08/2007
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