Provider Demographics
NPI:1801118625
Name:ALI, MIR AJMAL (RPH)
Entity type:Individual
Prefix:MR
First Name:MIR
Middle Name:AJMAL
Last Name:ALI
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 1:1230 NEPPERHAN AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703-1413
Mailing Address - Country:US
Mailing Address - Phone:914-969-7944
Mailing Address - Fax:914-969-3213
Practice Address - Street 1:1230 NEPPERHAN AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10703-1413
Practice Address - Country:US
Practice Address - Phone:914-969-7944
Practice Address - Fax:914-969-3213
Is Sole Proprietor?:No
Enumeration Date:2010-02-21
Last Update Date:2010-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045625183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist