Mantis, Jazila

Mantis, Jazila is an individual health care provider with primary practice located at 8268 164Th St , Jamaica NY 11432-1121. She recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as her primary health care specialty. Mantis, Jazila can be contacted via phone (718) 883-3225.

Contact Information

Primary practice address
8268 164Th St Jamaica NY 11432-1121
Fax: (718) 883-6193
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X 205564 New York

Profile Details

NPI number 1710082847
LBN Legal business name Mantis, Jazila
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2006
Last updated Nov 7th, 2011 - about 13 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 1710082847 NPPES
New York MEDICAID 00246075

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