| Doctor Name: | SHAHID S ALI |
| NPI Number: | 1376573733 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | NPP, FNP |
| License Number: | 333755 |
| Business Practice Address: | 451 Bromley Rd Churchville, NY - 144289784 |
| Business Phone Number: | 5856838515 |
| Business Fax Number: | |
| Mailing Address: | 451 Bromley Rd, CHURCHVILLE |
| State: | NY |
| Postal Code: | 144289784 |
| Phone Number: | 5856838515 |
| Fax Number: | |
| NPI Enumeration Date: | 07/03/2006 |
| NPI Last Update Date: | 02/19/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 333755 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |