Provider Demographics
NPI:1033587464
Name:ELSANAA, MAHMOUD ELSAYED (PHYSICAL THERAPY)
Entity Type:Individual
Prefix:MR
First Name:MAHMOUD
Middle Name:ELSAYED
Last Name:ELSANAA
Suffix:
Gender:M
Credentials:PHYSICAL THERAPY
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:28 LAKE DR W
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470
Mailing Address - Country:US
Mailing Address - Phone:718-760-8881
Mailing Address - Fax:718-760-8880
Practice Address - Street 1:86-09 51ST AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373
Practice Address - Country:US
Practice Address - Phone:718-760-8881
Practice Address - Fax:718-760-8880
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-02
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY038838-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist