Abdur R Jalazai MD PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

126123 Issued in NY

Legal business name

ABDUR R JALAZAI MD PC

Practice address

63 West Barney St
Gouverneur, NY 13642

Phone

(315) 287-1770

Fax

(315) 287-1170

NPI assigned

Sep 11, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Abdur R Jalalzai, MD

Title

Owner President Secretary

Phone

(315) 535-9229

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386748416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 WEST BARNEY ST",
            "city": "GOUVERNEUR",
            "state": "NY",
            "postal_code": "13642",
            "telephone_number": "315-287-1770",
            "fax_number": "315-287-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 WEST BARNEY ST",
            "city": "GOUVERNEUR",
            "state": "NY",
            "postal_code": "13642",
            "telephone_number": "315-287-1770",
            "fax_number": "315-287-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABDUR R JALAZAI MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JALALZAI",
        "authorized_official_first_name": "ABDUR",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER PRESIDENT SECRETARY",
        "authorized_official_telephone_number": "315-535-9229",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "126123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00615623",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aimee K Pecori OD PLLC
• Nabeel Alhussein, M.D.
• Penny Marie Allen, R.PH
• Diane R Andrews, RN
• .William Baerthlein, M.D.

• Internal Medicine Physician in Gouverneur, NY
• Providers in Gouverneur, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.