Individual
ALI JADDOA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
355 BARD AVE, STATEN ISLAND, NY 10310-1664
(718) 818-2419
Mailing address
355 BARD AVE BLDG 1, STATEN ISLAND, NY 10310-1664
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/30/2018
Last updated
04/30/2018
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