Individual
ZACK OMAR ALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14904 JEFFERSON DAVIS HWY STE 205, WOODBRIDGE, VA 22191-3908
(518) 530-2314
Mailing address
8 HARRISON AVE # 1, RENSSELAER, NY 12144-2126
(518) 530-2314
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/06/2020
Last updated
05/06/2020
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