Provider Demographics
NPI:1033091590
Name:SYED, ATIF ALI (PA-C)
Entity type:Individual
Prefix:
First Name:ATIF
Middle Name:ALI
Last Name:SYED
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:584 BOXWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SHIRLEY
Mailing Address - State:NY
Mailing Address - Zip Code:11967-1023
Mailing Address - Country:US
Mailing Address - Phone:631-312-8843
Mailing Address - Fax:
Practice Address - Street 1:584 BOXWOOD DR
Practice Address - Street 2:
Practice Address - City:SHIRLEY
Practice Address - State:NY
Practice Address - Zip Code:11967-1023
Practice Address - Country:US
Practice Address - Phone:631-312-8843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034102363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant