Fatehi, Jalal

Fatehi, Jalal is an sole proprietor health care provider with primary practice located at 22 Pheasant Run , Old Westbury NY 11568-1703. He recently has only one registered license in Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery, which is considered as his primary health care specialty. Fatehi, Jalal can be contacted via phone (516) 484-2959.

Contact Information

Primary practice address
22 Pheasant Run Old Westbury NY 11568-1703
Phone: (516) 484-2959
Fax: (516) 484-2154
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X 22DI01985000 New Jersey
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X 046724 New York

Profile Details

NPI number 1619193521
LBN Legal business name Fatehi, Jalal
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 18th, 2007
Last updated Oct 10th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619193521 NPPES
New York MEDICAID 01683834
New York MEDICAID 0457841

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