Provider Demographics
NPI:1417143371
Name:MOHSIN ALI, M.D. LLC
Entity Type:Organization
Organization Name:MOHSIN ALI, M.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHSIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-494-7725
Mailing Address - Street 1:400 PLAINFIELD RD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-2636
Mailing Address - Country:US
Mailing Address - Phone:732-494-7725
Mailing Address - Fax:732-494-5619
Practice Address - Street 1:400 PLAINFIELD RD
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-2636
Practice Address - Country:US
Practice Address - Phone:732-494-7725
Practice Address - Fax:732-494-5619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA06817900261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8707103Medicaid
094717Medicare PIN
G81224Medicare UPIN