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General NPI Number Information
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NPI Number | 1710478508
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Entity Type | Organization
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Legal Business Name | JALALUDDIN MEDICAL PLLC
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Dates
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Enumeration Date | 05/29/2018
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Last Update Date | 05/29/2018
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Provider Practice Location Address
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Address Line | 217 OLD ITHACA RD
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City | HORSEHEADS
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State | NY
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Zip | 14845-1778
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Country | US
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Telephone | 607-731-4644
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Fax | 607-442-0560
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Provider Business Mailing Address
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Address Line | 315 CHELSEA CT
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City | HORSEHEADS
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State | NY
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Zip | 14845-2244
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Country | US
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Telephone | 607-731-4644
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Fax | 607-442-0560
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Authorized Official
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Title or Position | OWNER
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Name | MUHAMMAD JALALUDDIN
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Credential | MD
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Telephone | 607-731-4644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 273984-1
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License Number State | NY
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