Provider Demographics
NPI:1578667218
Name:ALI, SHEHZAD (MD)
Entity type:Individual
Prefix:
First Name:SHEHZAD
Middle Name:
Last Name:ALI
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Gender:M
Credentials:MD
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Mailing Address - Street 1:90 PRESIDENTIAL PLAZA
Mailing Address - Street 2:FIRM C
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202
Mailing Address - Country:US
Mailing Address - Phone:518-926-5924
Mailing Address - Fax:518-926-6983
Practice Address - Street 1:90 PRESIDENTIAL PLAZA
Practice Address - Street 2:FIRM C
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202
Practice Address - Country:US
Practice Address - Phone:315-464-3834
Practice Address - Fax:315-464-3837
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2024-10-23
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Provider Licenses
StateLicense IDTaxonomies
NY203126207RN0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400157476Medicare PIN