Healthcare Provider Details

I. General information

NPI: 1316104466
Provider Name (Legal Business Name): TAHERA ALI D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2008
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 MEADOWLANDS PKWY
SECAUCUS NJ
07094-2925
US

IV. Provider business mailing address

3 UNIVERSITY PLZ STE 205
HACKENSACK NJ
07601-6208
US

V. Phone/Fax

Practice location:
  • Phone: 551-258-1975
  • Fax: 201-808-9421
Mailing address:
  • Phone: 973-290-7495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MB09099400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: