Provider Demographics
NPI:1730601956
Name:ALI, NASSER YASER (MD)
Entity type:Individual
Prefix:
First Name:NASSER
Middle Name:YASER
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 1:13856 TRENTON OVAL
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-8248
Mailing Address - Country:US
Mailing Address - Phone:440-212-8204
Mailing Address - Fax:
Practice Address - Street 1:13856 TRENTON OVAL
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-8248
Practice Address - Country:US
Practice Address - Phone:440-212-8204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.029858207R00000X
OH35.141097207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0430924Medicaid