Provider Demographics
NPI:1396630117
Name:ALI, DAVID AHMED
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:AHMED
Last Name:ALI
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 1:5100 LEESBURG PIKE STE 200G
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22302-1000
Mailing Address - Country:US
Mailing Address - Phone:571-234-7840
Mailing Address - Fax:
Practice Address - Street 1:5100 LEESBURG PIKE STE 200G
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22302-1000
Practice Address - Country:US
Practice Address - Phone:571-234-7840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-11
Last Update Date:2025-07-22
Deactivation Date:2025-06-11
Deactivation Code:
Reactivation Date:2025-07-22
Provider Licenses
StateLicense IDTaxonomies
VAHCO-0005909251E00000X, 385HR2060X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child