MEDICARE: DR. ALI HAMMOUD 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
1	207RC0000X	Cardiovascular Disease Physician	205896	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	060063476	OTHER	NY	RAIL ROAD MEDICARE

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
2	328Q433642	OTHER	NY	PTAN
3	328Q4X0942	OTHER	NY	PTAN
4	328Q4X0943	OTHER	NY	PTAN
6	328Q432241	OTHER	NY	PTAN

General Provider Information

NPI Number	:	1801899877
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALI HAMMOUD MD

Provider Business Mailing Address
First Line	:	1351 ROUTE 55
Second Line	:	STE 200
City	:	LAGRANGEVILLE
State	:	NY
Zip	:	12540-5128
Country	:	US
Telephone Number	:	845-475-9661
Fax Number	:	845-475-9938

Provider Business Practice Location Address
First Line	:	55 GRAND ST
Second Line	:	STE 106
City	:	KINGSTON
State	:	NY
Zip	:	12401-3933
Country	:	US
Telephone Number	:	845-339-8700
Fax Number	:	914-593-7881

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	03/13/2017

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Directions to “ DR. ALI HAMMOUD MD” Practice Location

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