Provider Demographics
NPI:1255511580
Name:KHEMILI, ALI (RPH)
Entity type:Individual
Prefix:MR
First Name:ALI
Middle Name:
Last Name:KHEMILI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:442 BALLTOWN RD
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12304-2245
Mailing Address - Country:US
Mailing Address - Phone:518-346-6218
Mailing Address - Fax:518-346-6384
Practice Address - Street 1:442 BALLTOWN RD
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12304-2245
Practice Address - Country:US
Practice Address - Phone:518-346-6218
Practice Address - Fax:518-346-6384
Is Sole Proprietor?:No
Enumeration Date:2007-11-03
Last Update Date:2007-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029227183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist