Provider Demographics
NPI:1619333630
Name:ALI, HADI
Entity Type:Individual
Prefix:
First Name:HADI
Middle Name:
Last Name:ALI
Suffix:
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 1:2508 PILLSBURY AVE S
Mailing Address - Street 2:108
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-4261
Mailing Address - Country:US
Mailing Address - Phone:952-217-0806
Mailing Address - Fax:612-225-1877
Practice Address - Street 1:2508 PILLSBURY AVE S
Practice Address - Street 2:108
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-4261
Practice Address - Country:US
Practice Address - Phone:952-217-0806
Practice Address - Fax:612-225-1877
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)