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General NPI Number Information
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NPI Number | 1811103153
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Entity Type | Organization
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Legal Business Name | DIALA JABER, MD, PC
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 04/10/2008
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Provider Practice Location Address
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Address Line | 232 E MAIN ST SUITE 2
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City | HUNTINGTON
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State | NY
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Zip | 11743-2920
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Country | US
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Telephone | 631-673-6669
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Fax | 631-673-6071
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Provider Business Mailing Address
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Address Line | 232 E MAIN ST SUITE 2
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City | HUNTINGTON
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State | NY
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Zip | 11743-2920
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Country | US
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Telephone | 631-673-6669
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Fax | 631-673-6071
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Authorized Official
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Title or Position | OWNER PHYSICIAN
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Name | DIALA JABER
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Credential | M.D.
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Telephone | 631-673-6669
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 196793
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License Number State | NY
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