Provider Demographics
NPI:1417268905
Name:ABO-DONIA, USAMA ELSEBAIE (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:USAMA
Middle Name:ELSEBAIE
Last Name:ABO-DONIA
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1461 BATH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-3818
Mailing Address - Country:US
Mailing Address - Phone:718-450-7070
Mailing Address - Fax:718-621-0777
Practice Address - Street 1:1461 BATH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-3818
Practice Address - Country:US
Practice Address - Phone:718-450-7070
Practice Address - Fax:718-621-0777
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015685-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist