Provider Demographics
NPI:1740963701
Name:DR. DANY Y. JABBOUR DPM PLLC
Entity type:Organization
Organization Name:DR. DANY Y. JABBOUR DPM PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCOTR
Authorized Official - Prefix:
Authorized Official - First Name:DANY
Authorized Official - Middle Name:YOUSSEF
Authorized Official - Last Name:JABBOUR
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:845-876-8637
Mailing Address - Street 1:91 MONTGOMERY ST STE 2
Mailing Address - Street 2:
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-1122
Mailing Address - Country:US
Mailing Address - Phone:845-876-8637
Mailing Address - Fax:
Practice Address - Street 1:91 MONTGOMERY ST STE 1
Practice Address - Street 2:
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-1122
Practice Address - Country:US
Practice Address - Phone:845-876-8637
Practice Address - Fax:845-876-0218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-08
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies