Provider Demographics
NPI:1891954442
Name:PAYAMI, ALI (MD, DMD)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:
Last Name:PAYAMI
Suffix:
Gender:M
Credentials:MD, DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2649 STRANG BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:YORKTOWN HTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-2939
Mailing Address - Country:US
Mailing Address - Phone:914-245-6642
Mailing Address - Fax:
Practice Address - Street 1:333 E 93RD ST APT 3P
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-5510
Practice Address - Country:US
Practice Address - Phone:617-901-3621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-07
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY255744204E00000X
NY0554761223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery