=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467628255
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SARA I ALI M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/01/2008
-----------------------------------------------------
Last Update Date | 06/04/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3100 QUAKERBRIDGE RD STE 2B
-----------------------------------------------------
City | HAMILTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08619-1658
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-689-7031
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4630 ROUTE 9 SOUTH
-----------------------------------------------------
City | HOWELL
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07731
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-370-0320
-----------------------------------------------------
Fax | 732-370-4558
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RG0300X
-----------------------------------------------------
Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
-----------------------------------------------------
License Number | 25MA08497400
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 25MA08497400
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------