Provider Demographics
NPI:1457875577
Name:JALAS, JOSEPH (MSED)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:JALAS
Suffix:
Gender:M
Credentials:MSED
Other - Prefix:MR
Other - First Name:JOSEPH
Other - Middle Name:
Other - Last Name:JALAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSED
Mailing Address - Street 1:17 TAFT CT
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-4139
Mailing Address - Country:US
Mailing Address - Phone:718-577-2240
Mailing Address - Fax:
Practice Address - Street 1:17 TAFT CT
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-4139
Practice Address - Country:US
Practice Address - Phone:718-577-2240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-31
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst