MEDICARE: CHRISTAL MARIE ALI 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	207Q00000X	Family Medicine Physician	10546	GA
2	207Q00000X	Family Medicine Physician	478148	PA

General Provider Information

NPI Number	:	1841797289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTAL MARIE ALI MD

Provider Business Mailing Address
First Line	:	500 OLD YORK RD
Second Line	:	STE 203
City	:	JENKINTOWN
State	:	PA
Zip	:	19046
Country	:	US
Telephone Number	:	478-633-5550
Fax Number	:	478-633-7287

Provider Business Practice Location Address
First Line	:	500 OLD YORK ROAD
Second Line	:	SUITE 203
City	:	JENKINTOWN
State	:	PA
Zip	:	19046
Country	:	US
Telephone Number	:	214-886-0174
Fax Number	:

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

Provider Enumeration Date	:	04/11/2018
Last Update Date	:	01/22/2026

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