MEDICARE: AKHTAR ALI

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
1	207L00000X	Anesthesiology Physician	206663	NY
2	208VP0000X	Pain Medicine Physician	206663	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659400679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AKHTAR ALI

Provider Business Mailing Address
First Line	:	PO BOX 170449
Second Line	:
City	:	OZONE PARK
State	:	NY
Zip	:	11417-0449
Country	:	US
Telephone Number	:	718-805-0594
Fax Number	:

Provider Business Practice Location Address
First Line	:	11004 JAMAICA AVE
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11418-2320
Country	:	US
Telephone Number	:	718-805-0594
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	03/09/2016

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Directions to “ AKHTAR ALI ” Practice Location

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