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NPI Code Detail

MEDICARE: DR. ALI MAHFUZ MD

MEDICARE: DR. ALI MAHFUZ MD
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
1390200000XStudent in an Organized Health Care Education/Training Program
2208D00000XGeneral Practice Physician341792NY

General Provider Information

NPI Number : 1689425969
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALI MAHFUZ MD
Provider Business Mailing Address
First Line : 475 SEAVIEW AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10305-3436
Country : US
Telephone Number : 718-226-6993
Fax Number :
Provider Business Practice Location Address
First Line : 475 SEAVIEW AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10305-3436
Country : US
Telephone Number : 718-226-6993
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2024
Last Update Date : 02/16/2026

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