Provider Demographics
NPI:1518396423
Name:MAHMOUD, MOHAMED (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:
Last Name:MAHMOUD
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:MOHAMED
Other - Middle Name:
Other - Last Name:MAHMOUD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:2027 85TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-3244
Mailing Address - Country:US
Mailing Address - Phone:347-977-9765
Mailing Address - Fax:
Practice Address - Street 1:316 86TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-5002
Practice Address - Country:US
Practice Address - Phone:718-238-4287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-01
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034933225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist