Provider Demographics
NPI:1609489772
Name:ALI, BUSHRA
Entity Type:Individual
Prefix:MRS
First Name:BUSHRA
Middle Name:
Last Name:ALI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BUSHRA
Other - Middle Name:
Other - Last Name:REHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:65 TREETOPS CIR
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-8587
Mailing Address - Country:US
Mailing Address - Phone:732-772-5180
Mailing Address - Fax:
Practice Address - Street 1:1086 TEANECK ROAD,
Practice Address - Street 2:SUITE 4A
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666
Practice Address - Country:US
Practice Address - Phone:201-862-9900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic