Provider Demographics
NPI:1891727343
Name:ALI ALBERT ANAIM DPM PC
Entity Type:Organization
Organization Name:ALI ALBERT ANAIM DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:ANAIM
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:215-423-9708
Mailing Address - Street 1:PO BOX 95000-1280
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-1280
Mailing Address - Country:US
Mailing Address - Phone:215-423-9708
Mailing Address - Fax:215-423-4173
Practice Address - Street 1:139 E LEHIGH AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19125-1011
Practice Address - Country:US
Practice Address - Phone:215-423-9708
Practice Address - Fax:215-423-4173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC004335L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4930900001Medicare NSC
PAU67172Medicare UPIN