Provider Demographics
NPI:1659948735
Name:ALI, HAFIZ SYED K
Entity Type:Individual
Prefix:
First Name:HAFIZ SYED
Middle Name:K
Last Name:ALI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 NORTHERN CT
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOPE
Mailing Address - State:WV
Mailing Address - Zip Code:25880-8842
Mailing Address - Country:US
Mailing Address - Phone:304-800-0262
Mailing Address - Fax:
Practice Address - Street 1:435 MAIN ST W
Practice Address - Street 2:
Practice Address - City:OAK HILL
Practice Address - State:WV
Practice Address - Zip Code:25901-3453
Practice Address - Country:US
Practice Address - Phone:304-465-7200
Practice Address - Fax:304-465-0377
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0011614183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist