Provider Demographics
NPI:1841308129
Name:ALI, AYESHA (MD)
Entity type:Individual
Prefix:DR
First Name:AYESHA
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 1:200 LOTHROP ST
Mailing Address - Street 2:FORBES TOWER, SUITE 9055
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2536
Mailing Address - Country:US
Mailing Address - Phone:412-647-3087
Mailing Address - Fax:412-647-4486
Practice Address - Street 1:1111 LOWRY AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:JEANNETTE
Practice Address - State:PA
Practice Address - Zip Code:15644-3063
Practice Address - Country:US
Practice Address - Phone:724-523-5721
Practice Address - Fax:724-527-6188
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038482L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1026344980001Medicaid
B41208Medicare UPIN
PA401033Medicare PIN