Provider Demographics
NPI:1235854514
Name:ALI, HALA ALI
Entity Type:Individual
Prefix:
First Name:HALA
Middle Name:ALI
Last Name:ALI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8934 ENGLEWOOD FARMS DR
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20112-5884
Mailing Address - Country:US
Mailing Address - Phone:860-900-9769
Mailing Address - Fax:
Practice Address - Street 1:12890 TOUCHSTONE CIR
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-7648
Practice Address - Country:US
Practice Address - Phone:703-590-0643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0015794183500000X
VA0202220351183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist