Provider Demographics
NPI:1437454188
Name:ALI, ASAD (MBBS)
Entity type:Individual
Prefix:
First Name:ASAD
Middle Name:
Last Name:ALI
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SUNY UPSTATE MEDICAL UNIVERSITY
Mailing Address - Street 2:750 E ADAMS ST, CWB 318
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210
Mailing Address - Country:US
Mailing Address - Phone:315-464-5804
Mailing Address - Fax:315-464-5809
Practice Address - Street 1:SUNY UPSTATE MEDICAL UNIVERSITY
Practice Address - Street 2:750 E ADAMS ST, CWB 318
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210
Practice Address - Country:US
Practice Address - Phone:315-464-5804
Practice Address - Fax:315-464-5809
Is Sole Proprietor?:No
Enumeration Date:2011-01-11
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA41366207R00000X
IAMD-41366208M00000X
NY319893207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist