Organization
ABDUR R JALAZAI MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ABDUR R JALALZAI MD (OWNER PRESIDENT SECRETARY)
(315) 535-9229
Entity
Organization
Contact information
Practice address
63 WEST BARNEY ST, GOUVERNEUR, NY 13642
(315) 287-1770
(315) 287-1170
Mailing address
63 WEST BARNEY ST, GOUVERNEUR, NY 13642
(315) 287-1770
(315) 287-1170
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
126123
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00615623
—
NY
Enumeration date
09/11/2006
Last updated
08/22/2020
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