Provider Demographics
NPI:1235104241
Name:ALI, STEVEN (OD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:ALI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2903 UNION ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-2202
Mailing Address - Country:US
Mailing Address - Phone:718-463-3412
Mailing Address - Fax:718-445-0867
Practice Address - Street 1:2903 UNION ST
Practice Address - Street 2:QUEENS EYE ASSOCIATES
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-2202
Practice Address - Country:US
Practice Address - Phone:718-463-3412
Practice Address - Fax:718-445-0867
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV0039581152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU19804Medicare UPIN
NY01210IMedicare PIN
NYC3A091Medicare PIN