Provider Demographics
NPI:1508519943
Name:HALABY, JAMIL RASHID III (NP)
Entity Type:Individual
Prefix:MR
First Name:JAMIL
Middle Name:RASHID
Last Name:HALABY
Suffix:III
Gender:M
Credentials:NP
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Mailing Address - Street 1:117 ELLENFIELD ST STE 101
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-4541
Mailing Address - Country:US
Mailing Address - Phone:401-444-6779
Mailing Address - Fax:401-444-6912
Practice Address - Street 1:950 WARREN AVE STE 201
Practice Address - Street 2:
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-1432
Practice Address - Country:US
Practice Address - Phone:855-332-8474
Practice Address - Fax:401-606-1153
Is Sole Proprietor?:No
Enumeration Date:2022-01-26
Last Update Date:2023-04-12
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Provider Licenses
StateLicense IDTaxonomies
390200000X
RIAPRN03533363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program