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General NPI Number Information
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NPI Number | 1851736466
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Entity Type | Organization
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Legal Business Name | SHAHID ALI NP PSYCHIATRY AND FAMILY MEDICINE PC
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Dates
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Enumeration Date | 05/09/2013
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Last Update Date | 05/09/2013
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Provider Practice Location Address
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Address Line | 4370 BUFFALO RD
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City | NORTH CHILI
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State | NY
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Zip | 14514-1206
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Country | US
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Telephone | 585-683-8515
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Fax |
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Provider Business Mailing Address
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Address Line | 4370 BUFFALO RD
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City | NORTH CHILI
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State | NY
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Zip | 14514-1206
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Country | US
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Telephone | 585-683-8515
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHAHID ALI
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Credential | NP, NPP
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Telephone | 585-683-8515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 333755
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 400972
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License Number State | NY
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