Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2014003237 | MO |
N | 111NI0900X | Internist | 2014003237 | MO |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | MD455981 | PA |
NPI | 1275771529 |
---|---|
Provider Name | Omaima A Ali |
First Address | Hershey, PA 17033-0858 |
Second Address | Hershey, PA 17033-2360 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2009 |
Last Update Date | 09/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1030874100001 | (05) | PA |