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
Phone: (718) 883-3225
Fax: (718) 883-6193
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710082847 | NPPES |
| New York | MEDICAID | 00246075 |
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