Individual
DR. ALI HAMMOUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 GRAND ST, STE 106, KINGSTON, NY 12401-3933
(845) 339-8700
(914) 593-7881
Mailing address
1351 ROUTE 55, STE 200, LAGRANGEVILLE, NY 12540-5128
(845) 475-9661
(845) 475-9938
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
205896
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02147473
—
NY
01
—
060063476
RAIL ROAD MEDICARE
NY
01
—
328Q432241
PTAN
NY
01
—
328Q433642
PTAN
NY
01
—
328Q4X0942
PTAN
NY
01
—
328Q4X0943
PTAN
NY
Enumeration date
05/24/2005
Last updated
03/13/2017
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