Provider Demographics
NPI:1457485336
Name:ABDELKADER, AHMED (PT)
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:
Last Name:ABDELKADER
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 1:638- 71ST ST
Mailing Address - Street 2:#3
Mailing Address - City:BROOKLYN,
Mailing Address - State:NY
Mailing Address - Zip Code:11209
Mailing Address - Country:US
Mailing Address - Phone:718-680-5679
Mailing Address - Fax:718-680-5640
Practice Address - Street 1:638- 71ST ST,
Practice Address - Street 2:APARTMENT #3
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209
Practice Address - Country:US
Practice Address - Phone:718-680-5679
Practice Address - Fax:718-680-5640
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020022225100000X
NY20022-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist