1467628255 NPI number — DR. SARA I ALI M.D.

Table of content: DR. SARA I ALI M.D. (NPI 1467628255)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467628255 NPI number — DR. SARA I ALI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALI
Provider First Name:
SARA
Provider Middle Name:
I
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
INAYET
Provider Other First Name:
SARA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1467628255
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/06/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4630 ROUTE 9 SOUTH
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOWELL
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07731
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-370-0320
Provider Business Mailing Address Fax Number:
732-370-4558

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3100 QUAKERBRIDGE RD STE 2B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAMILTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08619-1658
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-689-7031
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/01/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RG0300X , with the licence number:  25MA08497400 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 021336 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".