MEDICARE: HABIBULLAH JAMAL M.D

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
1	207Y00000X	Otolaryngology Physician	128157	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427137785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HABIBULLAH JAMAL M.D

Provider Business Mailing Address
First Line	:	14 RYE RIDGE PLAZA SUITE
Second Line	:	247
City	:	RYE BROOK
State	:	NY
Zip	:	10573
Country	:	US
Telephone Number	:	914-253-4985
Fax Number	:	914-253-4988

Provider Business Practice Location Address
First Line	:	14 RYE RIDGE PLZ STE 247
Second Line	:
City	:	RYE BROOK
State	:	NY
Zip	:	10573-2858
Country	:	US
Telephone Number	:	914-253-4985
Fax Number	:	914-253-4988

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	07/13/2021

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