Provider Demographics
NPI:1083764740
Name:ABDELMOAMEN, AHMED NABILE (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MS
First Name:AHMED
Middle Name:NABILE
Last Name:ABDELMOAMEN
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 GETZ AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-2176
Mailing Address - Country:US
Mailing Address - Phone:718-984-0015
Mailing Address - Fax:
Practice Address - Street 1:40 GETZ AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-2176
Practice Address - Country:US
Practice Address - Phone:718-984-0015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021390-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist