Basic Information
Provider Information
NPI: 1922032382
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALI
FirstName: JAMEEL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PA
OtherOrganizationName:  
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Mailing Information
Address1: 100 PARK STREET
Address2: GLENS FALLS HOSPITAL - CREDENTIALING
City: GLENS FALLS
State: NY
PostalCode: 128014413
CountryCode: US
TelephoneNumber: 5189265924
FaxNumber: 5189266983
Practice Location
Address1: 14 HUDSON AVENUE
Address2: ORTHOPEDIC SPECIALISTS OF GLENS FALLS HOSPITAL
City: GLENS FALLS
State: NY
PostalCode: 128014448
CountryCode: US
TelephoneNumber: 5189265600
FaxNumber: 5189265605
Other Information
ProviderEnumerationDate: 07/10/2006
LastUpdateDate: 09/03/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/19/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X  Y Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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