Abdiaziz Huruse Abdiali
Individual provider Active NPI Specialist · Burnsville, MN
NPI 1013782770 · NPPES record last updated Nov 21, 2023
Key facts
- NPI
- 1013782770
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- Practice address
- 100 River Ridge CT
Burnsville, MN 55337-1613 - Phone
- (612) 636-8746
- NPI assigned
- Nov 21, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fountain Autism Center LLC | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Yes |
Addresses
Primary practice location
100 River Ridge CT
Burnsville, MN 55337-1613
Mailing address
3628 Park Ave
Minneapolis, MN 55407-2533
Phone (612) 483-8729
Other providers in Burnsville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 21, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.