Provider Demographics
NPI:1164807970
Name:JELLOUL, FATIMA ZAHRA (MD)
Entity Type:Individual
Prefix:DR
First Name:FATIMA ZAHRA
Middle Name:
Last Name:JELLOUL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24510 GRAND CENTRAL PKWY
Mailing Address - Street 2:APT 5E
Mailing Address - City:BELLEROSE
Mailing Address - State:NY
Mailing Address - Zip Code:11426-2744
Mailing Address - Country:US
Mailing Address - Phone:914-815-6382
Mailing Address - Fax:
Practice Address - Street 1:24510 GRAND CENTRAL PKWY
Practice Address - Street 2:APT 5E
Practice Address - City:BELLEROSE
Practice Address - State:NY
Practice Address - Zip Code:11426-2744
Practice Address - Country:US
Practice Address - Phone:914-815-6382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-22
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program