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Individual

DR. JACK I JALLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
909 WALNUT ST, 2ND FLOOR, PHILADELPHIA, PA 19107-5211
(215) 955-7000
(215) 503-9170
Mailing address
909 WALNUT ST FL 2, PHILADELPHIA, PA 19107-5211

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
25MA06897900
NJ
207T00000X
Neurological Surgery Physician
C1-0013235
DE
207T00000X
Neurological Surgery Physician
Primary
MD048313L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001634580
PA
05
7226608
NJ
Enumeration date
10/12/2005
Last updated
03/12/2026
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