Provider Demographics
NPI:1326243098
Name:TAWDROS, GEORGE FAWZI (PT)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:FAWZI
Last Name:TAWDROS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6860 AUSTIN ST STE 404
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4219
Mailing Address - Country:US
Mailing Address - Phone:347-403-3241
Mailing Address - Fax:
Practice Address - Street 1:6860 AUSTIN ST STE 404
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4219
Practice Address - Country:US
Practice Address - Phone:718-275-4700
Practice Address - Fax:718-275-4744
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027797225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY027797OtherLICENSE NUMBER