Provider Demographics
NPI:1144527011
Name:ALI, REHAN (MD)
Entity type:Individual
Prefix:DR
First Name:REHAN
Middle Name:
Last Name:ALI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 MERCER LOOP
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-3233
Mailing Address - Country:US
Mailing Address - Phone:201-936-7712
Mailing Address - Fax:
Practice Address - Street 1:1144 E RIDGEWOOD AVE FL 2
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3941
Practice Address - Country:US
Practice Address - Phone:201-336-0188
Practice Address - Fax:201-336-0141
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-11
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA096685002081P2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine