Provider Demographics
NPI:1558092171
Name:AL ALI, ALI (PA)
Entity Type:Individual
Prefix:MR
First Name:ALI
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Last Name:AL ALI
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Gender:M
Credentials:PA
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Mailing Address - Street 1:251 SALINA MEADOWS PARKWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13212
Mailing Address - Country:US
Mailing Address - Phone:315-464-2000
Mailing Address - Fax:315-464-2010
Practice Address - Street 1:725 EAST ADAMS STREET
Practice Address - Street 2:3RD FLOOR
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210
Practice Address - Country:US
Practice Address - Phone:315-464-6527
Practice Address - Fax:315-464-1729
Is Sole Proprietor?:No
Enumeration Date:2022-06-23
Last Update Date:2023-12-27
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Provider Licenses
StateLicense IDTaxonomies
NY030795363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant