Provider Demographics
NPI:1346823705
Name:AHMED, ELHUSSEIN (PT, MSC)
Entity Type:Individual
Prefix:
First Name:ELHUSSEIN
Middle Name:
Last Name:AHMED
Suffix:
Gender:M
Credentials:PT, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 OCEAN PKWY APT 17E
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-8355
Mailing Address - Country:US
Mailing Address - Phone:646-644-3880
Mailing Address - Fax:212-722-9223
Practice Address - Street 1:2685 GRAND CONCOURSE APT 1G
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-3710
Practice Address - Country:US
Practice Address - Phone:646-644-3880
Practice Address - Fax:212-722-9223
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-04
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QP2000X
NY046522225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy