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NPI Code Detail

MEDICARE: ISSA E. JARADEH

MEDICARE:   ISSA E. JARADEH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician267440NY

General Provider Information

NPI Number : 1184955270
Entity Type Code : Individual
Provider Name (Legal Business Name) : ISSA E. JARADEH
Provider Business Mailing Address
First Line : 8723 RIDGE BLVD
Second Line : 2ND FLOOR
City : BROOKLYN
State : NY
Zip : 11209-4917
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 297 MARCUS GARVEY BLVD
Second Line :
City : BROOKLYN
State : NY
Zip : 11221-1114
Country : US
Telephone Number : 347-844-0705
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2010
Last Update Date : 03/07/2014

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Directions to “ ISSA E. JARADEH ” Practice Location

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