MEDICARE: ABID ALI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	104743-01	NY

General Provider Information

NPI Number	:	1912517160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABID ALI

Provider Business Mailing Address
First Line	:	7322 BAY PKWY APT C3
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-6036
Country	:	US
Telephone Number	:	917-808-5482
Fax Number	:

Provider Business Practice Location Address
First Line	:	1608 STILLWELL AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-1028
Country	:	US
Telephone Number	:	917-808-5482
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2020
Last Update Date	:	08/04/2020

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Directions to “ ABID ALI ” Practice Location

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