Healthcare Provider Details

I. General information

NPI: 1285478560
Provider Name (Legal Business Name): REYAD AL JABIRI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2024
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date: 02/03/2025
Reactivation Date: 05/19/2026

III. Provider practice location address

214 E. 149TH STREET
BRONX NY
10451
US

IV. Provider business mailing address

214 E. 149TH STREET
BRONX NY
10451
US

V. Phone/Fax

Practice location:
  • Phone: 718-579-5000
  • Fax: 718-579-4836
Mailing address:
  • Phone: 551-250-1298
  • Fax: 718-579-4836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: