Healthcare Provider Details

I. General information

NPI: 1851570139
Provider Name (Legal Business Name): ALI SALMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2007
Last Update Date: 02/29/2024
Certification Date: 02/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1161 VICTORY BLVD
STATEN ISLAND NY
10301-3621
US

IV. Provider business mailing address

343 4TH AVE APT 10C
BROOKLYN NY
11215-2723
US

V. Phone/Fax

Practice location:
  • Phone: 718-818-7449
  • Fax: 718-516-6428
Mailing address:
  • Phone: 718-818-7449
  • Fax: 718-516-6428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR8064
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number298306
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: