Provider Demographics
NPI:1326160961
Name:ALI, ALAN A (PA)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:A
Last Name:ALI
Suffix:
Gender:M
Credentials:PA
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Other - Middle Name:
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Mailing Address - Street 1:21 OLD HOPKINTON CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:ASHAWAY
Mailing Address - State:RI
Mailing Address - Zip Code:02804-2221
Mailing Address - Country:US
Mailing Address - Phone:401-315-5041
Mailing Address - Fax:401-315-5041
Practice Address - Street 1:13TH CIVIL SUPPORT TEAM
Practice Address - Street 2:570 READ SCHOOLHOUSE ROAD
Practice Address - City:COVENTRY
Practice Address - State:RI
Practice Address - Zip Code:02816
Practice Address - Country:US
Practice Address - Phone:401-392-0821
Practice Address - Fax:401-392-0822
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
RIPA00364363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant