Provider Demographics
NPI:1265686828
Name:ALKHAS, MARYAM FARZANEH (BS PHYSICAL THERAPY)
Entity Type:Individual
Prefix:MS
First Name:MARYAM
Middle Name:FARZANEH
Last Name:ALKHAS
Suffix:
Gender:F
Credentials:BS PHYSICAL THERAPY
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Mailing Address - Street 1:593 RIVERSIDE DR APT 3F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10031-8022
Mailing Address - Country:US
Mailing Address - Phone:646-425-9833
Mailing Address - Fax:212-283-8627
Practice Address - Street 1:593 RIVERSIDE DR APT 3F
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-8022
Practice Address - Country:US
Practice Address - Phone:646-425-9833
Practice Address - Fax:212-283-8627
Is Sole Proprietor?:No
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY012019-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics