Provider Demographics
NPI:1932810215
Name:MD ALLY SERVICES, PA
Entity Type:Organization
Organization Name:MD ALLY SERVICES, PA
Other - Org Name:MD ALLY TELEHEALTH SERVICES, PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:CLAY
Authorized Official - Last Name:MARINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-451-1781
Mailing Address - Street 1:348 W 57TH ST STE 180
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-3702
Mailing Address - Country:US
Mailing Address - Phone:203-350-2116
Mailing Address - Fax:866-326-5428
Practice Address - Street 1:4600 E WASHINGTON ST STE 300
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034-1908
Practice Address - Country:US
Practice Address - Phone:203-350-2116
Practice Address - Fax:866-326-5428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-08
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty