Healthcare Provider Details

I. General information

NPI: 1285321687
Provider Name (Legal Business Name): ABDULLAH ALI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2023
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

759 CHESTNUT ST STE C3350
SPRINGFIELD MA
01107-1619
US

IV. Provider business mailing address

280 CHESTNUT ST FL 2
SPRINGFIELD MA
01199-1001
US

V. Phone/Fax

Practice location:
  • Phone: 413-794-4320
  • Fax: 413-794-1767
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number1027652
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: