Provider Demographics
NPI:1417151622
Name:EL HALIM, ESMAT MOHAMMAD (PT)
Entity Type:Individual
Prefix:
First Name:ESMAT
Middle Name:MOHAMMAD
Last Name:EL HALIM
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 1:1755 JOHN F KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305-1900
Mailing Address - Country:US
Mailing Address - Phone:201-332-9988
Mailing Address - Fax:201-332-4552
Practice Address - Street 1:1755 JOHN F KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07305-1900
Practice Address - Country:US
Practice Address - Phone:201-332-9988
Practice Address - Fax:201-332-4552
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ261QP2000X
NJQA3103174400000X
174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy