Provider Demographics
NPI:1528227865
Name:AKHTAR ALI, MD PC
Entity Type:Organization
Organization Name:AKHTAR ALI, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:SAMINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-805-0504
Mailing Address - Street 1:PO BOX 170449
Mailing Address - Street 2:
Mailing Address - City:OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11417-0449
Mailing Address - Country:US
Mailing Address - Phone:718-805-0504
Mailing Address - Fax:718-848-7481
Practice Address - Street 1:10115 WOODHAVEN BLVD
Practice Address - Street 2:
Practice Address - City:OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11416-2314
Practice Address - Country:US
Practice Address - Phone:718-805-0504
Practice Address - Fax:718-848-7481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-02
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06642GMedicare UPIN