Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | 241307 | MA |
Y | 207RX0202X | Medical Oncology | 241307 | MA |
NPI | 1174751267 |
---|---|
Provider Name | Syed S Ali III |
First Address | Springfield, MA 01199-1001 |
Second Address | Springfield, MA 01107-1112 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2009 |
Last Update Date | 11/11/2016 |