Provider Demographics
NPI:1013388206
Name:ALI, JAMAL
Entity Type:Individual
Prefix:
First Name:JAMAL
Middle Name:
Last Name:ALI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3566 SULLIVANT AVE.
Mailing Address - Street 2:SUITE #201
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228-8226
Mailing Address - Country:US
Mailing Address - Phone:614-929-9866
Mailing Address - Fax:
Practice Address - Street 1:596 PLAYER CT
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:OH
Practice Address - Zip Code:43119-8226
Practice Address - Country:US
Practice Address - Phone:614-929-9866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-13
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No172A00000XOther Service ProvidersDriver