Provider Demographics
NPI:1174191472
Name:MALIK, ALI NOOR (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:NOOR
Last Name:MALIK
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 W 136TH ST FL 6
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-2104
Mailing Address - Country:US
Mailing Address - Phone:212-939-2877
Mailing Address - Fax:212-939-2886
Practice Address - Street 1:15 W 136TH ST FL 6
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-2104
Practice Address - Country:US
Practice Address - Phone:212-939-2877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-14
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program