Provider Demographics
NPI:1982380945
Name:SALEHI, SEYED-ALI
Entity type:Individual
Prefix:
First Name:SEYED-ALI
Middle Name:
Last Name:SALEHI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:ALI
Other - Middle Name:
Other - Last Name:SALEHI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:345 E. 24TH STREET
Mailing Address - Street 2:
Mailing Address - City:NEW YROK
Mailing Address - State:NY
Mailing Address - Zip Code:10010
Mailing Address - Country:US
Mailing Address - Phone:212-998-9800
Mailing Address - Fax:
Practice Address - Street 1:345 E. 24TH STREET
Practice Address - Street 2:
Practice Address - City:NEW YROK
Practice Address - State:NY
Practice Address - Zip Code:10010
Practice Address - Country:US
Practice Address - Phone:212-998-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ22DI030987001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program