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General NPI Number Information
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NPI Number | 1043831480
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Entity Type | Individual
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Provider Name | DR. ALASAN JALLOW
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Gender | Male
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Dates
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Enumeration Date | 04/27/2020
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Last Update Date | 04/27/2020
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Provider Practice Location Address
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Address Line | 3401 N BROAD ST
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City | PHILADELPHIA
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State | PA
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Zip | 19140-5103
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Country | US
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Telephone | 215-707-4735
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Fax | 856-566-1102
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Provider Business Mailing Address
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Address Line | 58 BRYCES CT
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City | SICKLERVILLE
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State | NJ
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Zip | 08081-1676
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Country | US
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Telephone | 215-850-5778
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Fax | 856-566-1102
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | RP442016
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License Number State | PA
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