Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | 25MS00020400 | NJ |
NPI | 1255925699 |
---|---|
Provider Name | Amal Aly |
First Address | Chatham, NJ 07928-1215 |
Second Address | Pine Brook, NJ 07058-9391 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2021 |
Last Update Date | 11/03/2021 |