Individual
DIANE MARIE ALY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
630 W 168TH ST, NEW YORK, NY 10032-3725
(212) 305-2862
Mailing address
485 MONROE AVENUE, WASHINGTON TWP, NJ 07676
(201) 388-7649
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
016933
NY
Other
Enumeration date
09/11/2013
Last updated
11/12/2019
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