Provider Demographics
NPI:1144674847
Name:JALEEL, SABAHATH HUMA (MD)
Entity type:Individual
Prefix:
First Name:SABAHATH
Middle Name:HUMA
Last Name:JALEEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1566 MEDICAL DR STE 104
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-3229
Mailing Address - Country:US
Mailing Address - Phone:484-945-0075
Mailing Address - Fax:484-945-7650
Practice Address - Street 1:1566 MEDICAL DR STE 104
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-3229
Practice Address - Country:US
Practice Address - Phone:484-945-0075
Practice Address - Fax:484-945-0781
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD475746207RR0500X
NJ25MA10391800208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist