Provider Demographics
NPI:1457504334
Name:MOHAMMED, ALI RAWI (DPT)
Entity Type:Individual
Prefix:
First Name:ALI
Middle Name:RAWI
Last Name:MOHAMMED
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 BAY 22ND ST
Mailing Address - Street 2:3 FL
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-6106
Mailing Address - Country:US
Mailing Address - Phone:646-662-2671
Mailing Address - Fax:
Practice Address - Street 1:230 BAY 22ND ST
Practice Address - Street 2:3 FL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-6106
Practice Address - Country:US
Practice Address - Phone:646-662-2671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-23
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016836225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist