Provider Demographics
NPI:1083403646
Name:ALI, SYED HASAN
Entity type:Individual
Prefix:
First Name:SYED HASAN
Middle Name:
Last Name:ALI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 CHILDREN'S AVENUE
Mailing Address - Street 2:A2, SUITE 14402
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104
Mailing Address - Country:US
Mailing Address - Phone:405-271-4417
Mailing Address - Fax:405-271-2920
Practice Address - Street 1:1200 CHILDREN'S AVENUE
Practice Address - Street 2:A2, SUITE 14402
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104
Practice Address - Country:US
Practice Address - Phone:405-271-4417
Practice Address - Fax:405-271-2920
Is Sole Proprietor?:No
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program