Provider Demographics
NPI:1225274541
Name:MOSTAFA PC
Entity Type:Organization
Organization Name:MOSTAFA PC
Other - Org Name:ADVANCED REHABILITATION AND THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:HASSAN
Authorized Official - Last Name:MOSTAFA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:703-401-7344
Mailing Address - Street 1:7 POST OFFICE RD STE E
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-2744
Mailing Address - Country:US
Mailing Address - Phone:703-401-7344
Mailing Address - Fax:703-333-5952
Practice Address - Street 1:7 POST OFFICE RD STE E
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-2744
Practice Address - Country:US
Practice Address - Phone:703-401-7344
Practice Address - Fax:703-333-5952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-17
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22257261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy