Provider Demographics
NPI:1336469030
Name:OSMAN, YEHIA S (DPT)
Entity Type:Individual
Prefix:
First Name:YEHIA
Middle Name:S
Last Name:OSMAN
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 1:790 RICHMOND RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-2420
Mailing Address - Country:US
Mailing Address - Phone:718-876-1950
Mailing Address - Fax:718-732-1678
Practice Address - Street 1:790 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-2420
Practice Address - Country:US
Practice Address - Phone:718-876-1950
Practice Address - Fax:718-732-1678
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-03
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018595225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400067623Medicare PIN