MEDICARE: DR. MALIK ALI DC

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	111N00000X	Chiropractor	DC011980	PA

General Provider Information

NPI Number	:	1902624745
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MALIK ALI DC

Provider Business Mailing Address
First Line	:	5105 N PARK DR APT 222
Second Line	:
City	:	PENNSAUKEN
State	:	NJ
Zip	:	08109-4630
Country	:	US
Telephone Number	:	956-617-1104
Fax Number	:

Provider Business Practice Location Address
First Line	:	5429 CHESTNUT ST STE G19
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19139-3325
Country	:	US
Telephone Number	:	956-617-1104
Fax Number	:

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

Provider Enumeration Date	:	10/01/2024
Last Update Date	:	10/01/2024

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Directions to “ DR. MALIK ALI DC” Practice Location

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