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Individual

ALI AHMADIZADEH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
875 OLD COUNTRY RD, PLAINVIEW, NY 11803-4942
(516) 931-5552
Mailing address
875 OLD COUNTRY RD, PLAINVIEW, NY 11803-4942
(516) 931-5552

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
254098
NY
207Y00000X
Otolaryngology Physician
Primary
254098
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03239012
NY
Enumeration date
05/23/2006
Last updated
03/30/2021
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