=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376039529
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MAAZ JALIL D.O.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/10/2018
-----------------------------------------------------
Last Update Date | 02/19/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10 MADISON AVE FL 3
-----------------------------------------------------
City | MORRISTOWN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07960-7327
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-507-7750
-----------------------------------------------------
Fax | 973-507-7752
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 660 WHITE PLAINS RD FL 4
-----------------------------------------------------
City | TARRYTOWN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10591-5187
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-333-5801
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207K00000X
-----------------------------------------------------
Taxonomy Name | Allergy & Immunology Physician
-----------------------------------------------------
License Number | 25MB10922600
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------