Basic Information
| Provider Information | |||||||||
| NPI: | 1174722268 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHAH | ||||||||
| FirstName: | ALI | ||||||||
| MiddleName: | AHSEN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6045 VALLEY FORGE DR | ||||||||
| Address2: | |||||||||
| City: | COOPERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180368806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142025282 | ||||||||
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| Practice Location | |||||||||
| Address1: | 30 N 4TH ST FL 1 | ||||||||
| Address2: | |||||||||
| City: | LEBANON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170465606 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172707500 | ||||||||
| FaxNumber: | 7177218751 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2007 | ||||||||
| LastUpdateDate: | 04/05/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | MD445423 | PA | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.