Provider Demographics
NPI:1285154559
Name:ALI, FARISA (MD)
Entity type:Individual
Prefix:
First Name:FARISA
Middle Name:
Last Name:ALI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 W BAY AVE
Mailing Address - Street 2:
Mailing Address - City:BARNEGAT
Mailing Address - State:NJ
Mailing Address - Zip Code:08005-1289
Mailing Address - Country:US
Mailing Address - Phone:609-994-5688
Mailing Address - Fax:609-607-4025
Practice Address - Street 1:912 W BAY AVE
Practice Address - Street 2:
Practice Address - City:BARNEGAT
Practice Address - State:NJ
Practice Address - Zip Code:08005-1289
Practice Address - Country:US
Practice Address - Phone:609-994-5688
Practice Address - Fax:609-607-4025
Is Sole Proprietor?:No
Enumeration Date:2017-06-27
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10755600208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist