Provider Demographics
NPI:1568244770
Name:ABDI-MOTI, TYLER M
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:M
Last Name:ABDI-MOTI
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 1:17 MONTAGUE PL
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2808
Mailing Address - Country:US
Mailing Address - Phone:973-281-7595
Mailing Address - Fax:
Practice Address - Street 1:17 MONTAGUE PL
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-2808
Practice Address - Country:US
Practice Address - Phone:973-281-7595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty