| Doctor Name: | HENDA BOUALI |
| NPI Number: | 1053495465 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 246796 |
| Business Practice Address: | 4417 Vestal Parkway East Suite 202 Vestal, NY - 138503556 |
| Business Phone Number: | 6077707365 |
| Business Fax Number: | 6077295882 |
| Mailing Address: | 346 Grand Ave, JOHNSON CITY |
| State: | NY |
| Postal Code: | 137902580 |
| Phone Number: | 6077298156 |
| Fax Number: | 6077293982 |
| NPI Enumeration Date: | 10/24/2006 |
| NPI Last Update Date: | 09/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RR0500X |
| License Number: | 246796 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Rheumatology |
| Taxonomy Definition: | An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases. |