Individual provider Active NPI

Alfred Jalloh, FNP-BC

  • Family Nurse Practitioner
  • White Plains, NY
National Provider Identifier
1104472042
Registry record updated Aug 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
344768 Issued in NY
Practice address
4 W Red Oak LN Ste 310
White Plains, NY 10604-3606
Phone
(914) 719-6079
NPI assigned
Aug 15, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 344768 NY Primary

Addresses

Primary practice location

4 W Red Oak LN Ste 310
White Plains, NY 10604-3606

Mailing address

18 Paerdegat 4TH St
Brooklyn, NY 11236-4136
Phone (718) 930-3317

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
344768NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1104472042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 PAERDEGAT 4TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364136",
            "telephone_number": "718-930-3317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 W RED OAK LN STE 310",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106043606",
            "telephone_number": "914-719-6079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JALLOH",
        "first_name": "ALFRED",
        "name_prefix": "Mr.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-15",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "344768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.