Provider Demographics
NPI:1447420948
Name:ALI S. HALABI, M.D., INC
Entity Type:Organization
Organization Name:ALI S. HALABI, M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:S
Authorized Official - Last Name:HALABI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-883-1234
Mailing Address - Street 1:PO BOX 41194
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44141-0194
Mailing Address - Country:US
Mailing Address - Phone:216-883-1234
Mailing Address - Fax:
Practice Address - Street 1:5316 BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44127-1507
Practice Address - Country:US
Practice Address - Phone:216-883-1234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35045146261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0448779Medicaid
OH0898141Medicare PIN
OHA08156Medicare UPIN