Provider Demographics
NPI:1346404902
Name:ALI, PREETHA (MD)
Entity Type:Individual
Prefix:DR
First Name:PREETHA
Middle Name:
Last Name:ALI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 IRVING ST NW STE 2100N
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2927
Mailing Address - Country:US
Mailing Address - Phone:202-877-8484
Mailing Address - Fax:202-877-8483
Practice Address - Street 1:106 IRVING ST NW STE 2100N
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2927
Practice Address - Country:US
Practice Address - Phone:202-877-8484
Practice Address - Fax:202-877-8483
Is Sole Proprietor?:No
Enumeration Date:2008-07-14
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME148704208C00000X
MDD0084106208C00000X
DCMD210002850208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL109619400Medicaid
FLNJ758OtherMEDICARE HF