Provider Demographics
NPI:1215367289
Name:IRSHAD ALI, MD
Entity Type:Organization
Organization Name:IRSHAD ALI, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRSHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-835-5869
Mailing Address - Street 1:357 ENGLEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14223-2807
Mailing Address - Country:US
Mailing Address - Phone:716-835-5869
Mailing Address - Fax:716-835-5879
Practice Address - Street 1:357 ENGLEWOOD AVE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14223-2807
Practice Address - Country:US
Practice Address - Phone:716-835-5869
Practice Address - Fax:716-835-5879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-12
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty