Provider Demographics
NPI:1851734578
Name:ALI, MOHSIN (DSW)
Entity Type:Individual
Prefix:DR
First Name:MOHSIN
Middle Name:
Last Name:ALI
Suffix:
Gender:M
Credentials:DSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:652 VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-5445
Mailing Address - Country:US
Mailing Address - Phone:631-682-6612
Mailing Address - Fax:718-278-7846
Practice Address - Street 1:652 VERNON AVE
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-5445
Practice Address - Country:US
Practice Address - Phone:631-682-6612
Practice Address - Fax:718-278-7846
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-11
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY062669104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker