Provider Demographics
NPI:1225573611
Name:ANNA JAQUES INPATIENT SPECIALISTS PLLC
Entity Type:Organization
Organization Name:ANNA JAQUES INPATIENT SPECIALISTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:A
Authorized Official - Last Name:JALEEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-685-2460
Mailing Address - Street 1:47 HIGH ST
Mailing Address - Street 2:STE 101
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-5201
Mailing Address - Country:US
Mailing Address - Phone:978-685-2460
Mailing Address - Fax:978-685-2572
Practice Address - Street 1:25 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-3867
Practice Address - Country:US
Practice Address - Phone:978-685-2460
Practice Address - Fax:978-685-2572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-21
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty