Individual
TARIK A ALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PROVIDER
Contact information
Practice address
12 WILCOX ST, WETHERSFIELD, CT 06109-1250
(860) 328-9450
Mailing address
12 WILCOX ST, WETHERSFIELD, CT 06109-1250
(860) 328-9450
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
01/26/2020
Last updated
01/26/2020
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