Jallo, Jack I
Jallo, Jack I is an individual health care provider with primary practice located at 909 Walnut St 2Nd Floor, Philadelphia PA 19107-5211. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Jallo, Jack I can be contacted via phone (215) 955-7000.Contact Information
Primary practice address
909 Walnut St 2Nd Floor
Philadelphia PA 19107-5211
Phone: (215) 955-7000
Fax: (215) 503-9170
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurological Surgery | 207T00000X | 25MA06897900 | New Jersey |
| Allopathic & Osteopathic Physicians / Neurological Surgery | 207T00000X | MD048313L | Pennsylvania |
Profile Details
| NPI number | 1720076706 |
|---|---|
| LBN Legal business name | Jallo, Jack I |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 12th, 2005 |
| Last updated | Nov 20th, 2018 - about 6 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 | 1720076706 | NPPES |
| Pennsylvania | MEDICAID | 001634580 | |
| Pennsylvania | MEDICAID | 7226608 |
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