Moussa Jaradeh
Dentist, General Practice in New York, NY. Individual provider (NPI-1).
NPI number1174209258
StatusActive
Last updated in NPPESJun 27, 2025
Details
- NPI
- 1174209258
- Entity type
- Individual (NPI-1)
- Name
- Moussa Jaradeh
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 23, 2023
- Certification date
- Jun 27, 2025
- Last updated
- Jun 27, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 064654 | NY | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
345 E 24th StNew York, NY 10010-4020
Phone 212-998-9800
Mailing address
345 E 24th StNew York, NY 10010-4020
Phone 212-998-9800
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