Organization
SHIBRAH M. JAMIL, MD, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHIBRAH JAMIL MD (PRESIDENT)
(917) 975-4163
Entity
Organization
Contact information
Practice address
11412 BEACH CHANNEL DR STE 10, ROCKAWAY PARK, NY 11694-2212
(718) 318-0800
Mailing address
15747 ROSE AVE, FLUSHING, NY 11355-2327
(917) 975-4163
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
261QP3300X
Pain Clinic/Center
—
—
Other
Enumeration date
07/22/2020
Last updated
11/10/2020
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