Jallo, Jack I

Jallo, Jack I is an individual health care provider with primary practice located at 909 Walnut St 2Nd Floor, Philadelphia PA 19107-5211. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Jallo, Jack I can be contacted via phone (215) 955-7000.

Contact Information

Primary practice address
909 Walnut St 2Nd Floor Philadelphia PA 19107-5211
Phone: (215) 955-7000
Fax: (215) 503-9170
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 25MA06897900 New Jersey
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X MD048313L Pennsylvania

Profile Details

NPI number 1720076706
LBN Legal business name Jallo, Jack I
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2005
Last updated Nov 20th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720076706 NPPES
Pennsylvania MEDICAID 001634580
Pennsylvania MEDICAID 7226608

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