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:
Health care specialties
| Specialty | Code | License # | 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 3 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 | 1144373929 | NPPES |
| New York | Other | CJ9902 | RAILROAD MEDICARE |
| New York | MEDICAID | 01770869 | RAILROAD MEDICARE |
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