NPI 1134584535 · live from the CMS NPI Registry
Shazi Ali
Nurse Practitioner in Bridgeport, CT. National Provider Identifier 1134584535, active.
NPI record
| NPI | 1134584535 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner 363L00000X |
| Practice location | 4920 Main St, Bridgeport, CT 06606 |
| Practice phone | 860-380-5150 |
| Mailing address | 79 Golden Hill St, Trumbull, CT 06611 |
| Enumerated | December 29, 2015 |
| Last updated | November 27, 2024 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner primary | 363L00000X | 6424 (CT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.