1497733224 NPI number — JAMIL SARFRAZ MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497733224 NPI number — JAMIL SARFRAZ MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

SARFRAZ

Provider First Name:

JAMIL

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1497733224

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

08/11/2021

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

4372 ROUTE 6

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

KANE

Provider Business Mailing Address State Name:

PA

Provider Business Mailing Address Postal Code:

16735-3060

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

814-837-4580

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

4372 ROUTE 6

Provider Second Line Business Practice Location Address:

KANE COMMUNITY HOSPITAL

Provider Business Practice Location Address City Name:

KANE

Provider Business Practice Location Address State Name:

PA

Provider Business Practice Location Address Postal Code:

16735-3060

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

814-837-4580

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

01/03/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 2085R0202X , with the licence number:  25MA02868500 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2085R0202X , with the licence number: MD421668 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
• Taxonomy code: 2085R0202X , with the licence number: 107886 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

• Identifier: P010107886 . This is a "BC OF ROCHESTER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: P00189577 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 00578574 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
• Identifier: 000526552016 . This is a "BC WNY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 001582412 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 101421672 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
• Identifier: 000786371 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
• Identifier: 1190363 . This is a "IHA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: P00057797 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".