Provider Demographics
NPI:1952296428
Name:ABUALI, ADLI S SR
Entity type:Individual
Prefix:MR
First Name:ADLI
Middle Name:S
Last Name:ABUALI
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:NJ
Mailing Address - Zip Code:08065-1916
Mailing Address - Country:US
Mailing Address - Phone:215-869-1297
Mailing Address - Fax:
Practice Address - Street 1:917 GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:NJ
Practice Address - Zip Code:08065-1916
Practice Address - Country:US
Practice Address - Phone:215-869-1297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJA10740108205872172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver