Provider Demographics
NPI:1134009335
Name:OMAYAN, ALI
Entity type:Individual
Prefix:
First Name:ALI
Middle Name:
Last Name:OMAYAN
Suffix:
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 1:10031 BERGIN RD STE G
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-7049
Mailing Address - Country:US
Mailing Address - Phone:313-414-0841
Mailing Address - Fax:
Practice Address - Street 1:10031 BERGIN RD STE G
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-7049
Practice Address - Country:US
Practice Address - Phone:313-414-0841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XR0403XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistDriving and Community MobilityGroup - Single Specialty