Provider Demographics
NPI:1073646535
Name:ELSAYED, MOHAMED SALAH (BACHELOR DEGREE)
Entity Type:Individual
Prefix:MR
First Name:MOHAMED
Middle Name:SALAH
Last Name:ELSAYED
Suffix:
Gender:M
Credentials:BACHELOR DEGREE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 4TH AVE APT 518
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-3949
Mailing Address - Country:US
Mailing Address - Phone:917-607-0088
Mailing Address - Fax:718-745-4217
Practice Address - Street 1:1075 OCEAN VIEW AVE
Practice Address - Street 2:1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-5405
Practice Address - Country:US
Practice Address - Phone:718-891-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY23526174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist