Provider Demographics
NPI:1013230697
Name:MORNING STAR PHYSICAL THERAPY P.C
Entity Type:Organization
Organization Name:MORNING STAR PHYSICAL THERAPY P.C
Other - Org Name:MORNING STAR PHYSICAL THERAPY P.C
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:Y
Authorized Official - Last Name:ELSAIDY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:718-969-6100
Mailing Address - Street 1:77-16 164 STREET
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11366
Mailing Address - Country:US
Mailing Address - Phone:718-969-6100
Mailing Address - Fax:718-969-6103
Practice Address - Street 1:77-16 164 STREET
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366
Practice Address - Country:US
Practice Address - Phone:718-969-6100
Practice Address - Fax:718-969-6103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026231174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty