Provider Demographics
NPI:1962685693
Name:ABDALI, SYED A
Entity Type:Individual
Prefix:MR
First Name:SYED
Middle Name:A
Last Name:ABDALI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7117 ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-6136
Mailing Address - Country:US
Mailing Address - Phone:718-899-8200
Mailing Address - Fax:718-899-8202
Practice Address - Street 1:7117 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6136
Practice Address - Country:US
Practice Address - Phone:718-899-8200
Practice Address - Fax:718-899-8202
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-17
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY29782183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist