Organization
MD ALLY SERVICES PA
Active
Other names
MD Ally Telehealth Services PA
Organization subpart
No
Provider details
NPI number
Authorized official
SHANEL FIELDS (CHIEF OFFICER)
(212) 287-4250
Entity
Organization
Contact information
Practice address
7900 OAK LN STE 400, MIAMI LAKES, FL 33016-6001
(925) 212-1114
Mailing address
348 W 57TH ST STE 180, NEW YORK, NY 10019-3702
(203) 350-2116
(866) 326-5428
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114428800
—
FL
05
—
147196
—
AZ
Enumeration date
11/08/2021
Last updated
09/16/2024
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