Individual
ALI M GHARAGOZLOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
214 KING ST, OGDENSBURG, NY 13669-1142
(315) 393-3600
(315) 393-9127
Mailing address
4567 CROSSROADS PARK DR, LIVERPOOL, NY 13088-3589
(315) 434-9307
(315) 434-9317
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
198556
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01686460
—
NY
Enumeration date
08/26/2005
Last updated
09/12/2007
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