Provider Demographics
NPI:1942645544
Name:ALABI, DAVID O (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:O
Last Name:ALABI
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 FERRY ST STE 2
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07105-1436
Mailing Address - Country:US
Mailing Address - Phone:973-589-3566
Mailing Address - Fax:973-589-1707
Practice Address - Street 1:18 FERRY ST STE 2
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07105-1436
Practice Address - Country:US
Practice Address - Phone:973-589-3566
Practice Address - Fax:973-589-1707
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-08
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY#33 338715363LF0000X
NJ26NJ00418900363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY# 338715OtherFAMILY PRACTICE NURSE
NJ82-4723243Medicaid