Healthcare Provider Details

I. General information

NPI: 1043737265
Provider Name (Legal Business Name): JONATHAN ALHALEL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2017
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 MERRIMACK ST STE 9
LAWRENCE MA
01843-1764
US

IV. Provider business mailing address

360 MERRIMACK ST STE 9
LAWRENCE MA
01843-1764
US

V. Phone/Fax

Practice location:
  • Phone: 978-688-6182
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number1028219
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: