MEDICARE: MR. JOSEPH ALI N.P.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	401554	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417238403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSEPH ALI N.P.P.

Provider Business Mailing Address
First Line	:	1 VAN DALE CT
Second Line	:
City	:	WOODSTOCK
State	:	NY
Zip	:	12498-2615
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 MARSHALL RD STE 2L
Second Line	:
City	:	WAPPINGERS FALLS
State	:	NY
Zip	:	12590-4134
Country	:	US
Telephone Number	:	845-679-5262
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2011
Last Update Date	:	06/11/2021

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