MEDICARE: DR. ALI MARDINI M.D.

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1821885138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALI MARDINI M.D.

Provider Business Mailing Address
First Line	:	100 EILEEN DONDERO FOLEY AVE GRADUATE MEDICAL EDUCATION
Second Line	:	SUITE 110
City	:	PORTSMOUTH
State	:	NH
Zip	:	03801
Country	:	US
Telephone Number	:	603-559-4129
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 EILEEN DONDERO FOLEY AVE GRADUATE MEDICAL EDUCATION
Second Line	:	SUITE 110
City	:	PORTSMOUTH
State	:	NH
Zip	:	03801
Country	:	US
Telephone Number	:	603-559-4129
Fax Number	:

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

Provider Enumeration Date	:	04/21/2025
Last Update Date	:	12/12/2025

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