Provider Demographics
NPI:1851011217
Name:ALI, MUNIBAH RAHAT (AUD)
Entity Type:Individual
Prefix:
First Name:MUNIBAH
Middle Name:RAHAT
Last Name:ALI
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 N PENNINGTON RD
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-1620
Mailing Address - Country:US
Mailing Address - Phone:848-200-6643
Mailing Address - Fax:
Practice Address - Street 1:8620 SW 103RD STREET RD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481-7705
Practice Address - Country:US
Practice Address - Phone:848-200-6643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY2640231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist