Provider Demographics
NPI:1154017986
Name:AL-SHAIKHLI, MUSTAFA MOHAMMED ALI M (MD)
Entity type:Individual
Prefix:
First Name:MUSTAFA
Middle Name:MOHAMMED ALI M
Last Name:AL-SHAIKHLI
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 1:355 GRANT ST.
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302
Mailing Address - Country:US
Mailing Address - Phone:201-915-2431
Mailing Address - Fax:201-915-2219
Practice Address - Street 1:355 GRANT ST.
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302
Practice Address - Country:US
Practice Address - Phone:201-915-2431
Practice Address - Fax:201-915-2219
Is Sole Proprietor?:No
Enumeration Date:2023-04-14
Last Update Date:2024-10-17
Deactivation Date:2023-11-17
Deactivation Code:
Reactivation Date:2024-10-17
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program