Provider Demographics
NPI:1285017111
Name:BEKHET, ISLAM MOHAMED (DPT)
Entity Type:Individual
Prefix:DR
First Name:ISLAM
Middle Name:MOHAMED
Last Name:BEKHET
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 E PALISADE AVE
Mailing Address - Street 2:APT 14J
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-3161
Mailing Address - Country:US
Mailing Address - Phone:347-935-2876
Mailing Address - Fax:
Practice Address - Street 1:1500 ASTOR AVE
Practice Address - Street 2:STE 2B
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-5900
Practice Address - Country:US
Practice Address - Phone:718-975-8274
Practice Address - Fax:718-975-8277
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-09
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037190-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist