Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | LP00186 | RI |
N | 111NI0900X | Internist | LP00186 | RI |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 25MA0950400 | NJ |
NPI | 1245455799 |
---|---|
Provider Name | Sameer Jamal |
First Address | Montvale, NJ 07645-2300 |
Second Address | Hackensack, NJ 07601-1997 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2007 |
Last Update Date | 16/09/2016 |