Provider Demographics
NPI:1710352695
Name:SYED-ALI, MARIUM ZEHRA (PA-C)
Entity Type:Individual
Prefix:
First Name:MARIUM
Middle Name:ZEHRA
Last Name:SYED-ALI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 MACK BLVD FL 4
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-5622
Mailing Address - Country:US
Mailing Address - Phone:484-884-0552
Mailing Address - Fax:484-884-0628
Practice Address - Street 1:2649 SCHOENERSVILLE RD STE 202
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7316
Practice Address - Country:US
Practice Address - Phone:434-239-0627
Practice Address - Fax:434-237-0345
Is Sole Proprietor?:No
Enumeration Date:2015-12-03
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110-005153363A00000X
PA363AM0700X
PAMA058159363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical