Provider Demographics
NPI:1114256237
Name:ALI H GOLI MD PC
Entity Type:Organization
Organization Name:ALI H GOLI MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:H
Authorized Official - Last Name:GOLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-584-3085
Mailing Address - Street 1:37 KNOLLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02030-2422
Mailing Address - Country:US
Mailing Address - Phone:617-584-3085
Mailing Address - Fax:
Practice Address - Street 1:37 KNOLLWOOD DR
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:MA
Practice Address - Zip Code:02030-2422
Practice Address - Country:US
Practice Address - Phone:617-584-3085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-19
Last Update Date:2009-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA234469261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
1548473911OtherPIN