Healthcare Provider Details

I. General information

NPI: 1306265087
Provider Name (Legal Business Name): SAMER ALI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2014
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 PELHAM PKWY S
BRONX NY
10461-1197
US

IV. Provider business mailing address

1400 PELHAM PKWY S
BRONX NY
10461-1138
US

V. Phone/Fax

Practice location:
  • Phone: 718-918-4826
  • Fax:
Mailing address:
  • Phone: 347-984-3016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number304740
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: