Provider Demographics
NPI:1376659375
Name:SAID, THARWAT
Entity Type:Individual
Prefix:
First Name:THARWAT
Middle Name:
Last Name:SAID
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 ABATE CT
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-7353
Mailing Address - Country:US
Mailing Address - Phone:732-246-0665
Mailing Address - Fax:732-246-0776
Practice Address - Street 1:79 VERONICA AVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-3448
Practice Address - Country:US
Practice Address - Phone:732-246-0665
Practice Address - Fax:732-246-0776
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00575800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ081620Medicare ID - Type UnspecifiedPHYSICAL THERAPY