Provider Demographics
NPI:1417488578
Name:ASSEM PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:ASSEM PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASSEM
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:AWAD
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:347-492-4200
Mailing Address - Street 1:5506 AVENUE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-4006
Mailing Address - Country:US
Mailing Address - Phone:347-492-4200
Mailing Address - Fax:347-492-4080
Practice Address - Street 1:5506 AVENUE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-4006
Practice Address - Country:US
Practice Address - Phone:347-492-4200
Practice Address - Fax:347-492-4080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-21
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty