Provider Demographics
NPI:1992773378
Name:ALJARI, JAMAL M (MD)
Entity type:Individual
Prefix:DR
First Name:JAMAL
Middle Name:M
Last Name:ALJARI
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 1:1001 9TH AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:BRACKENRIDGE
Mailing Address - State:PA
Mailing Address - Zip Code:15014-1107
Mailing Address - Country:US
Mailing Address - Phone:724-393-1756
Mailing Address - Fax:724-704-3460
Practice Address - Street 1:1001 9TH AVE STE 2
Practice Address - Street 2:
Practice Address - City:BRACKENRIDGE
Practice Address - State:PA
Practice Address - Zip Code:15014-1107
Practice Address - Country:US
Practice Address - Phone:724-393-1756
Practice Address - Fax:724-704-3460
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME89195207R00000X
CAA85836207R00000X
PAMD423471207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102168345-0002Medicaid