Provider Demographics
NPI:1053731778
Name:ALI, HECKMAT I
Entity type:Individual
Prefix:
First Name:HECKMAT
Middle Name:
Last Name:ALI
Suffix:I
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:273 ALBANY AVE APT 1B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-2738
Mailing Address - Country:US
Mailing Address - Phone:917-340-2961
Mailing Address - Fax:
Practice Address - Street 1:425 PROSPECT PL APT 5J
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-4166
Practice Address - Country:US
Practice Address - Phone:917-340-2691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-21
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY679356163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse