Active NPI
Ali Nicole Dana, MD,PHD
- Dermatology Physician
- Bronx, NY
National Provider Identifier
1063620300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 257184
- Practice address
- 130 W Kingsbridge Rd
Bronx, NY 10468-3904 - Phone
- (718) 584-9000
- NPI assigned
- May 18, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 257184 | NY | Primary |
Addresses
Primary practice location
130 W Kingsbridge Rd
Bronx, NY 10468-3904
Mailing address
130 W Kingsbridge Rd Ste 2F
Bronx, NY 10468-3904
Phone (718) 584-9000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 257184 | NY | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695686400000",
"number": "1063620300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 W KINGSBRIDGE RD STE 2F",
"city": "BRONX",
"state": "NY",
"postal_code": "104683904",
"telephone_number": "718-584-9000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 W KINGSBRIDGE RD",
"city": "BRONX",
"state": "NY",
"postal_code": "104683904",
"telephone_number": "718-584-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANA",
"first_name": "ALI",
"middle_name": "NICOLE",
"name_prefix": "Dr.",
"credential": "MD,PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-18",
"last_updated": "2023-09-26",
"certification_date": "2023-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NY",
"license": "257184",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.