Provider Demographics
NPI:1508311929
Name:ALI, MALIKAH
Entity Type:Individual
Prefix:MS
First Name:MALIKAH
Middle Name:
Last Name:ALI
Suffix:
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 1:175 REMSEN ST
Mailing Address - Street 2:TRICENTER SUITE 625
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4333
Mailing Address - Country:US
Mailing Address - Phone:718-858-4050
Mailing Address - Fax:718-858-4137
Practice Address - Street 1:175 REMSEN ST
Practice Address - Street 2:TRICENTER SUITE 625
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4333
Practice Address - Country:US
Practice Address - Phone:718-858-4050
Practice Address - Fax:718-858-4137
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)