Provider Demographics
NPI:1205319324
Name:JIBRIL, JALAL (PHARMD)
Entity type:Individual
Prefix:
First Name:JALAL
Middle Name:
Last Name:JIBRIL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4722
Mailing Address - Country:US
Mailing Address - Phone:347-599-1008
Mailing Address - Fax:
Practice Address - Street 1:180 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4722
Practice Address - Country:US
Practice Address - Phone:347-599-1008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-14
Last Update Date:2025-02-13
Deactivation Date:2018-09-14
Deactivation Code:
Reactivation Date:2018-10-31
Provider Licenses
StateLicense IDTaxonomies
NY064607183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist