Healthcare Provider Details

I. General information

NPI: 1083819593
Provider Name (Legal Business Name): JAMAL AL TAANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2007
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

565 ABBOTT RD
BUFFALO NY
14220-2039
US

IV. Provider business mailing address

144 GENESEE ST FL 3
BUFFALO NY
14203-1560
US

V. Phone/Fax

Practice location:
  • Phone: 716-826-7000
  • Fax:
Mailing address:
  • Phone: 716-206-1510
  • Fax: 716-961-4368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number35.090765
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number335057
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number35.090765
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number109430
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number77516
License Number StateTN
# 6
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number55667
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: