Healthcare Provider Details

I. General information

NPI: 1841743622
Provider Name (Legal Business Name): ALHARITH ALJANABI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2016
Last Update Date: 08/06/2024
Certification Date: 08/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 SEAVIEW AVE
STATEN ISLAND NY
10305-3436
US

IV. Provider business mailing address

145 LINCOLN AVE APT 4P
STATEN ISLAND NY
10306-3322
US

V. Phone/Fax

Practice location:
  • Phone: 718-226-9000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberFA0316996
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: