Mahdavian, Jamal

Mahdavian, Jamal is an individual health care provider with primary practice located at 40 Hurley Ave Suite 5 , Kingston NY 12401. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Mahdavian, Jamal can be contacted via phone (845) 338-9488.

Contact Information

Primary practice address
40 Hurley Ave Suite 5 Kingston NY 12401
Phone: (845) 338-9488
Fax: (845) 338-6774
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 207514-1 New York

Profile Details

NPI number 1144373929
LBN Legal business name Mahdavian, Jamal
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2007
Last updated Dec 8th, 2021 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144373929 NPPES
New York Other CJ9902 RAILROAD MEDICARE
New York MEDICAID 01770869 RAILROAD MEDICARE

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