Al-Mudamgha, Ali A

Al-Mudamgha, Ali A is an individual health care provider with primary practice located at 4820 W Taft Rd Suite 209, Liverpool NY 13088-2800. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology. Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology is his primary health care specialty. Al-Mudamgha, Ali A can be contacted via phone (315) 448-6215.

Contact Information

Primary practice address
4820 W Taft Rd Suite 209 Liverpool NY 13088-2800
Phone: (315) 448-6215
Fax: (315) 234-4416
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 187031 New York
Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology 207RC0001X 187031 New York

Profile Details

NPI number 1144216649
LBN Legal business name Al-Mudamgha, Ali A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2005
Last updated May 29th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144216649 NPPES
New York MEDICAID 01742805

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