Zack Omar Ali
Individual provider Active NPI Counselor · Woodbridge, VA
NPI 1689295149 · NPPES record last updated May 6, 2020
Key facts
- NPI
- 1689295149
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 14904 Jefferson Davis Hwy Ste 205
Woodbridge, VA 22191-3908 - Phone
- (518) 530-2314
- NPI assigned
- May 6, 2020
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
14904 Jefferson Davis Hwy Ste 205
Woodbridge, VA 22191-3908
Mailing address
8 Harrison Ave # 1
Rensselaer, NY 12144-2126
Phone (518) 530-2314
Other providers in Woodbridge, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 6, 2020. 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.