Provider Demographics
NPI:1003150640
Name:GRAMERCY PARK PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:GRAMERCY PARK PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YEHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:718-285-2706
Mailing Address - Street 1:173 TULIP AVE
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-2703
Mailing Address - Country:US
Mailing Address - Phone:718-285-2706
Mailing Address - Fax:516-407-5189
Practice Address - Street 1:173 TULIP AVE
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-2703
Practice Address - Country:US
Practice Address - Phone:718-285-2706
Practice Address - Fax:516-407-5189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-20
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031486261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy