Provider Demographics
NPI:1548498413
Name:ALI, ZERAH (DPM)
Entity type:Individual
Prefix:
First Name:ZERAH
Middle Name:
Last Name:ALI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5786 WIDEWATERS PKWY STE 2
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13214-1840
Mailing Address - Country:US
Mailing Address - Phone:315-251-3140
Mailing Address - Fax:315-552-6046
Practice Address - Street 1:5719 WIDEWATERS PKWY
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13214-1985
Practice Address - Country:US
Practice Address - Phone:315-251-3100
Practice Address - Fax:315-449-9923
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2024-05-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYN006464-1213E00000X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist