Individual provider · NPI-1
Justin Ali
Recreational Therapist Assistant · Englewood, NJ
NPI number1487384756
StatusActive
Last updated in NPPESJun 10, 2022
Details
- NPI
- 1487384756
- Entity type
- Individual (NPI-1)
- Name
- Justin Ali
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 10, 2022
- Certification date
- Jun 6, 2022
- Last updated
- Jun 10, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 226000000X | Recreational Therapist Assistant | – | – | Yes |
Practice location
155-175 W Hudson AveEnglewood, NJ 07631
Phone 201-803-8669
Mailing address
115 Lakeside BlvdOakland, NJ 07436-3904
Phone 201-803-8669
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