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NPI Code Detail

MEDICARE: TAHERA ALI D.O.

MEDICARE: TAHERA ALI D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician25MB09099400NJ

General Provider Information

NPI Number : 1316104466
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAHERA ALI D.O.
Provider Business Mailing Address
First Line : 3 UNIVERSITY PLZ STE 205
Second Line :
City : HACKENSACK
State : NJ
Zip : 07601-6208
Country : US
Telephone Number : 973-290-7495
Fax Number :
Provider Business Practice Location Address
First Line : 38 MEADOWLANDS PKWY
Second Line :
City : SECAUCUS
State : NJ
Zip : 07094-2925
Country : US
Telephone Number : 551-258-1975
Fax Number : 201-808-9421
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2008
Last Update Date : 05/28/2026

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Directions to “ TAHERA ALI D.O.” Practice Location

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