Provider Demographics
NPI:1922816784
Name:ALI, ABIZER (PT, APRN, AGNP-C)
Entity type:Individual
Prefix:MR
First Name:ABIZER
Middle Name:
Last Name:ALI
Suffix:
Gender:M
Credentials:PT, APRN, AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29983 CLUB HOUSE LN
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2019
Mailing Address - Country:US
Mailing Address - Phone:248-797-3233
Mailing Address - Fax:248-522-7289
Practice Address - Street 1:21999 FARMINGTON RD STE 200
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MI
Practice Address - Zip Code:48336-4420
Practice Address - Country:US
Practice Address - Phone:248-522-7258
Practice Address - Fax:248-522-7289
Is Sole Proprietor?:No
Enumeration Date:2024-12-26
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704367708363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health