Provider Demographics
NPI:1669829107
Name:ALY, JASMINE M (MD)
Entity Type:Individual
Prefix:DR
First Name:JASMINE
Middle Name:M
Last Name:ALY
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 1:66 YORK ST STE 301
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-3838
Mailing Address - Country:US
Mailing Address - Phone:201-275-0010
Mailing Address - Fax:
Practice Address - Street 1:66 YORK ST STE 301
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-3838
Practice Address - Country:US
Practice Address - Phone:201-275-0010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-13
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ25MA10035100207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA10035100OtherNJ BOARD OF MEDICAL EXAMINERS