Provider Demographics
NPI:1003237165
Name:ANTOUN, GEORGE FOUAD (PT, DPT)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:FOUAD
Last Name:ANTOUN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 BAY 48TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-6848
Mailing Address - Country:US
Mailing Address - Phone:347-827-7203
Mailing Address - Fax:347-702-4434
Practice Address - Street 1:232 BAY 48TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-6848
Practice Address - Country:US
Practice Address - Phone:347-827-7203
Practice Address - Fax:347-702-4434
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-16
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025986-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist