Provider Demographics
NPI:1700509452
Name:AHMED ALI, USAMA (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:USAMA
Middle Name:
Last Name:AHMED ALI
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:JOHANNES VERMEERHAGE 45
Mailing Address - Street 2:
Mailing Address - City:NIEUWEGEIN
Mailing Address - State:UTRECHT
Mailing Address - Zip Code:3437NM
Mailing Address - Country:NL
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:161 FORT WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3729
Practice Address - Country:US
Practice Address - Phone:212-342-1155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY318235208C00000X
NY318235-01208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery