Provider Demographics
NPI:1497127849
Name:ALI, SELMA I
Entity Type:Individual
Prefix:
First Name:SELMA
Middle Name:
Last Name:ALI
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 OCEAN PKWY APT SUPER
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-2460
Mailing Address - Country:US
Mailing Address - Phone:646-203-6541
Mailing Address - Fax:
Practice Address - Street 1:160 OCEAN PKWY APT SUPER
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-2460
Practice Address - Country:US
Practice Address - Phone:646-203-6541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-26
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist