Healthcare Provider Details

I. General information

NPI: 1023082666
Provider Name (Legal Business Name): NABIL JAMAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 12/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 E 4TH ST
DUNKIRK NY
14048-2226
US

IV. Provider business mailing address

166 E 4TH ST
DUNKIRK NY
14048-2226
US

V. Phone/Fax

Practice location:
  • Phone: 716-203-6474
  • Fax: 716-363-1235
Mailing address:
  • Phone: 716-203-6474
  • Fax: 716-363-1235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberX001664
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: