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General NPI Number Information
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NPI Number | 1932810215
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Entity Type | Organization
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Legal Business Name | MD ALLY SERVICES PA
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Dates
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Enumeration Date | 12/08/2022
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Last Update Date | 09/16/2024
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Provider Practice Location Address
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Address Line | 4600 E WASHINGTON ST STE 300
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City | PHOENIX
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State | AZ
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Zip | 85034-1908
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Country | US
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Telephone | 203-350-2116
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Fax | 866-326-5428
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Provider Business Mailing Address
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Address Line | 348 W 57TH ST STE 180
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City | NEW YORK
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State | NY
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Zip | 10019-3702
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Country | US
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Telephone | 203-350-2116
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Fax | 866-326-5428
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MRS. MEGAN CLAY MARINO
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Credential | MD
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Telephone | 504-451-1781
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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