MEDICARE: IMRAN AHMED JAMIL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	274118	NY
2	2084P0800X	Psychiatry Physician	25MA09550500	NJ

General Provider Information

NPI Number	:	1396056065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IMRAN AHMED JAMIL M.D.

Provider Business Mailing Address
First Line	:	340 MERCER LOOP
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07302-3233
Country	:	US
Telephone Number	:	646-379-5927
Fax Number	:

Provider Business Practice Location Address
First Line	:	506 HAMBURG TPKE STE 209
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-2069
Country	:	US
Telephone Number	:	973-720-9300
Fax Number	:	201-335-0835

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2010
Last Update Date	:	06/27/2026

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