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Individual
MR. DERECK ALI
Active
Individual
MR. DERECK ALI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
561703-01
NY
163WE0003X
Emergency Registered Nurse
561703-01
NY
Other
Enumeration date
03/23/2023
Last updated
03/23/2023
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