Provider Demographics
NPI:1174680722
Name:ALY, SAYED R (MD)
Entity Type:Individual
Prefix:DR
First Name:SAYED
Middle Name:R
Last Name:ALY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-3623
Mailing Address - Country:US
Mailing Address - Phone:201-471-7790
Mailing Address - Fax:201-471-7789
Practice Address - Street 1:451 BROADWAY
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-3623
Practice Address - Country:US
Practice Address - Phone:201-471-7790
Practice Address - Fax:201-471-7789
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA45070208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1927205Medicaid
NJ1927205Medicaid