Provider Demographics
NPI:1972863819
Name:ALI, TANZINA (OTR/L)
Entity type:Individual
Prefix:
First Name:TANZINA
Middle Name:
Last Name:ALI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 MCGRAW AVE
Mailing Address - Street 2:APT. 4A
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-7972
Mailing Address - Country:US
Mailing Address - Phone:347-851-0284
Mailing Address - Fax:
Practice Address - Street 1:1919 MCGRAW AVE
Practice Address - Street 2:APT. 4A
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-7972
Practice Address - Country:US
Practice Address - Phone:347-851-0284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0174141225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist