Islam, Ali Mohammed Waliul

Islam, Ali Mohammed Waliul is an individual health care provider with primary practice located at 5 Grace Church St , Port Chester NY 10573-4911. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Islam, Ali Mohammed Waliul can be contacted via phone (914) 937-8899.

Contact Information

Primary practice address
5 Grace Church St Port Chester NY 10573-4911
Phone: (914) 937-8899
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 253012 New York

Profile Details

NPI number 1235369463
LBN Legal business name Islam, Ali Mohammed Waliul
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 22nd, 2009
Last updated Oct 23rd, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235369463 NPPES
New York MEDICAID 03147037

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