Provider Demographics
NPI:1073360368
Name:MOHAMMEDALI, MAJDEDDIN AHMAD KHALED (MD)
Entity type:Individual
Prefix:
First Name:MAJDEDDIN
Middle Name:AHMAD KHALED
Last Name:MOHAMMEDALI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MAJDEDDIN
Other - Middle Name:AHMAD KHALED
Other - Last Name:MOHAMMED ALI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:121 DEKALB AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201
Mailing Address - Country:US
Mailing Address - Phone:718-250-6604
Mailing Address - Fax:
Practice Address - Street 1:121 DEKALB AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201
Practice Address - Country:US
Practice Address - Phone:718-250-6604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-03
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program