Provider Demographics
NPI:1194249565
Name:JALOUDI, MOHAMMED ALI (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:ALI
Last Name:JALOUDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 863
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:NJ
Mailing Address - Zip Code:07620-0863
Mailing Address - Country:US
Mailing Address - Phone:201-665-6510
Mailing Address - Fax:
Practice Address - Street 1:104 ADAMS CT
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:07020-1651
Practice Address - Country:US
Practice Address - Phone:201-888-3853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-27
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06157700207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology