Provider Demographics
NPI:1073544748
Name:PALI, ROZAFA L (MD)
Entity Type:Individual
Prefix:DR
First Name:ROZAFA
Middle Name:L
Last Name:PALI
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 1:789 WARING AVE
Mailing Address - Street 2:SUITE LA
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-9275
Mailing Address - Country:US
Mailing Address - Phone:718-231-5111
Mailing Address - Fax:718-708-4767
Practice Address - Street 1:789 WARING AVE APT LA
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-9275
Practice Address - Country:US
Practice Address - Phone:718-231-5111
Practice Address - Fax:718-708-4767
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY222063-1207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02202413Medicaid
NY508D61Medicare ID - Type Unspecified
NY02202413Medicaid