Functional Wellness Medical Care PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FUNCTIONAL WELLNESS MEDICAL CARE PLLC

Practice address

16055 Cross Bay Blvd
Unit a
Howard Beach, NY 11414-3450

Phone

(718) 210-4738

Fax

(888) 498-4123

NPI assigned

Oct 21, 2022

Organization subpart

No

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

Authorized official

Name

Hamza Jalal, MDNPI 1164910667

Title

Owner

Phone

(631) 572-9139

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.

• Hamza Jalal, DO

  • Family Medicine Physician
  • Howard Beach, NY
  • NPI 1164910667
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1666310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1164149001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16055 CROSS BAY BLVD",
            "address_2": "UNIT A",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114143450",
            "telephone_number": "718-210-4738",
            "fax_number": "888-498-4123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16055 CROSS BAY BLVD",
            "address_2": "UNIT A",
            "city": "HOWARD BEACH",
            "state": "NY",
            "postal_code": "114143450",
            "telephone_number": "718-210-4738",
            "fax_number": "888-498-4123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL WELLNESS MEDICAL CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-21",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A",
        "authorized_official_last_name": "JALAL",
        "authorized_official_first_name": "HAMZA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-572-9139",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Friedman
• Anna Frogiero, PHARMD
• Howard N Fuchter, DDS
• David Scott Fuggetta, D.C.
• Skyy Fulcher, RN
• Jennifer Ann Furno
• Stephanie Nicole Gabriel, FNP
• Gabriella Gaitan
• Mary Catherine Gallagher
• Concetta Gallo, LMFT

• Family Medicine Physician in Howard Beach, NY
• Providers in Howard Beach, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.