Provider Demographics
NPI:1497733224
Name:SARFRAZ, JAMIL (MD)
Entity Type:Individual
Prefix:
First Name:JAMIL
Middle Name:
Last Name:SARFRAZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4372 ROUTE 6
Mailing Address - Street 2:
Mailing Address - City:KANE
Mailing Address - State:PA
Mailing Address - Zip Code:16735-3060
Mailing Address - Country:US
Mailing Address - Phone:814-837-4580
Mailing Address - Fax:
Practice Address - Street 1:4372 ROUTE 6
Practice Address - Street 2:KANE COMMUNITY HOSPITAL
Practice Address - City:KANE
Practice Address - State:PA
Practice Address - Zip Code:16735-3060
Practice Address - Country:US
Practice Address - Phone:814-837-4580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-03
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA028685002085R0202X
PAMD4216682085R0202X
NY1078862085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP010107886OtherBC OF ROCHESTER
PAP00189577OtherRAILROAD MEDICARE
NY00578574Medicaid
NY000526552016OtherBC WNY
PA001582412OtherHIGHMARK BLUE SHIELD
PA101421672Medicaid
PA000786371Medicaid
NY1190363OtherIHA
NYP00057797OtherRAILROAD MEDICARE
PA000786371Medicaid
NYDD6714Medicare PIN
NY1190363OtherIHA