Abed Al-Mawla Jandali M.D. PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

ABED AL-MAWLA JANDALI M.D. PC

Practice address

13 Arch St
Green Island, NY 12183-1329

Phone

(518) 274-4654

Fax

(518) 274-4654

NPI assigned

Dec 18, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Abed Al-Mawla Jandali PC, M.D.

Title

Owner

Phone

(518) 274-4654

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Abed Al-Mawla Jandali, M.D.

  • Surgery Physician
  • Green Island, NY
  • NPI 1003918277
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1355788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714521600000",
    "number": "1083950117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 ARCH ST",
            "city": "GREEN ISLAND",
            "state": "NY",
            "postal_code": "121831329",
            "telephone_number": "518-274-4654",
            "fax_number": "518-274-4654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 ARCH ST",
            "city": "GREEN ISLAND",
            "state": "NY",
            "postal_code": "121831329",
            "telephone_number": "518-274-4654",
            "fax_number": "518-274-4654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABED AL-MAWLA JANDALI M.D. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-18",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A",
        "authorized_official_last_name": "JANDALI PC",
        "authorized_official_first_name": "ABED",
        "authorized_official_middle_name": "AL-MAWLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "518-274-4654",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Angert, MD
• Brianne Mary Burke
• David Gerard Cornell, D.D.S.
• Jennifer Donovan
• Empire Home Infusion Service Inc

• Primary Care Clinic/Center in Green Island, NY
• Providers in Green Island, NY by specialty
• Primary Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.