Provider Demographics
NPI:1710478508
Name:JALALUDDIN MEDICAL PLLC
Entity Type:Organization
Organization Name:JALALUDDIN MEDICAL PLLC
Other - Org Name:JALALUDDIN MEDICAL PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:JALALUDDIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:607-731-4644
Mailing Address - Street 1:315 CHELSEA CT
Mailing Address - Street 2:
Mailing Address - City:HORSEHEADS
Mailing Address - State:NY
Mailing Address - Zip Code:14845-2244
Mailing Address - Country:US
Mailing Address - Phone:607-731-4644
Mailing Address - Fax:607-442-0560
Practice Address - Street 1:217 OLD ITHACA RD
Practice Address - Street 2:
Practice Address - City:HORSEHEADS
Practice Address - State:NY
Practice Address - Zip Code:14845-1778
Practice Address - Country:US
Practice Address - Phone:607-731-4644
Practice Address - Fax:607-442-0560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY273984-1207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty