Provider Demographics
NPI:1093056871
Name:SPHINX I PT PC
Entity Type:Organization
Organization Name:SPHINX I PT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:AMAL
Authorized Official - Last Name:ELAZHARY
Authorized Official - Suffix:
Authorized Official - Credentials:PHDPT
Authorized Official - Phone:347-607-0555
Mailing Address - Street 1:1924 60TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-2345
Mailing Address - Country:US
Mailing Address - Phone:347-607-0555
Mailing Address - Fax:
Practice Address - Street 1:1924 60TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-2345
Practice Address - Country:US
Practice Address - Phone:347-607-0555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-05
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty