Healthcare Provider Details

I. General information

NPI: 1457707325
Provider Name (Legal Business Name): SHIREEN JALAL HIJAZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2016
Last Update Date: 11/01/2023
Certification Date: 11/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

967 N BROADWAY
YONKERS NY
10701-1301
US

IV. Provider business mailing address

2214 KATANA PL
BRANDON FL
33511-6318
US

V. Phone/Fax

Practice location:
  • Phone: 914-964-4444
  • Fax:
Mailing address:
  • Phone: 813-417-7772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number299925
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: