Provider Demographics
NPI:1407347156
Name:HASSANEIN, AHMED MOHAMED KADRY (PT BSC DPT)
Entity Type:Individual
Prefix:MR
First Name:AHMED
Middle Name:MOHAMED KADRY
Last Name:HASSANEIN
Suffix:
Gender:M
Credentials:PT BSC DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8537 58TH AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4811
Mailing Address - Country:US
Mailing Address - Phone:646-944-3923
Mailing Address - Fax:
Practice Address - Street 1:6860 AUSTIN ST STE 307
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4223
Practice Address - Country:US
Practice Address - Phone:718-880-1716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040885225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist