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:
Health care specialties
| Specialty | Code | License # | 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 2 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619193521 | NPPES |
| New York | MEDICAID | 01683834 | |
| New York | MEDICAID | 0457841 |
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