Provider Demographics
NPI:1770259723
Name:ALI, SHOAIB (RN)
Entity Type:Individual
Prefix:
First Name:SHOAIB
Middle Name:
Last Name:ALI
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 HUNTER LN
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-2400
Mailing Address - Country:US
Mailing Address - Phone:609-304-2413
Mailing Address - Fax:
Practice Address - Street 1:30 HUNTER LN
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-2400
Practice Address - Country:US
Practice Address - Phone:609-304-2241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY805439163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse