Individual
ALI BAHADORI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 CYPRESS ST, BROOKLINE, MA 02445-6002
(617) 582-1253
(617) 582-1197
Mailing address
111 CYPRESS ST, BROOKLINE, MA 02445-6002
(617) 582-1253
(617) 582-1197
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
234278
MA
207R00000X
Internal Medicine Physician
MD068226L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017453190001
—
PA
Enumeration date
05/08/2006
Last updated
02/19/2008
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