Provider Demographics
NPI:1194186791
Name:ALI, BILAL SR
Entity Type:Individual
Prefix:
First Name:BILAL
Middle Name:
Last Name:ALI
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 JEFFERSON ST
Mailing Address - Street 2:SUITE 389
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105-1622
Mailing Address - Country:US
Mailing Address - Phone:862-368-7512
Mailing Address - Fax:
Practice Address - Street 1:188 JEFFERSON ST
Practice Address - Street 2:SUITE 389
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105-1622
Practice Address - Country:US
Practice Address - Phone:862-368-7512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-10
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty