Provider Demographics
NPI:1639709090
Name:UMALI, ALEXANDER JR
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:UMALI
Suffix:JR
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 1:55 NASSAU PL APT 2F
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-4458
Mailing Address - Country:US
Mailing Address - Phone:909-251-5433
Mailing Address - Fax:
Practice Address - Street 1:55 NASSAU PL APT 2F
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-4458
Practice Address - Country:US
Practice Address - Phone:909-251-5433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-23
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045190-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist