Provider Demographics
NPI:1619083177
Name:ALI, RANA Y (MD)
Entity Type:Individual
Prefix:DR
First Name:RANA
Middle Name:Y
Last Name:ALI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 BINGHAM AVENUE, SUITE B
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712
Mailing Address - Country:US
Mailing Address - Phone:732-575-1100
Mailing Address - Fax:732-575-1107
Practice Address - Street 1:301 BINGHAM AVENUE, SUITE B
Practice Address - Street 2:
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712
Practice Address - Country:US
Practice Address - Phone:732-575-1100
Practice Address - Fax:732-575-1107
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY234396207RP1001X
NJ25MA08978700207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02691716Medicaid
NJ031335Medicaid
NJ02691716Medicaid
NY02691716Medicaid
NJ8V1611Medicare PIN
NYA400001730Medicare PIN
NY143848Medicare UPIN