Provider Demographics
NPI:1801337878
Name:ALI, FATIMA
Entity type:Individual
Prefix:
First Name:FATIMA
Middle Name:
Last Name:ALI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10703 VENETIA MILL CIR
Mailing Address - Street 2:APT. 3B
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-1597
Mailing Address - Country:US
Mailing Address - Phone:301-975-7397
Mailing Address - Fax:
Practice Address - Street 1:10703 VENETIA MILL CIR
Practice Address - Street 2:APT. 3B
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-1597
Practice Address - Country:US
Practice Address - Phone:301-975-7397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-10
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA12522374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide