MEDICARE: ABDEL JABAR ALLADE LIGALI

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	172A00000X	Driver

General Provider Information

NPI Number	:	1730023409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABDEL JABAR ALLADE LIGALI

Provider Business Mailing Address
First Line	:	451 NORTHEN PKW
Second Line	:
City	:	UNIONDALE
State	:	NY
Zip	:	11553
Country	:	US
Telephone Number	:	929-253-1203
Fax Number	:	347-778-5933

Provider Business Practice Location Address
First Line	:	473 BERGEN ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11217-4040
Country	:	US
Telephone Number	:	347-796-5933
Fax Number	:	347-778-5933

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

Provider Enumeration Date	:	04/15/2026
Last Update Date	:	04/15/2026

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