Provider Demographics
NPI:1528599636
Name:ABD-ALMONUM, AHMAD (PT)
Entity Type:Individual
Prefix:
First Name:AHMAD
Middle Name:
Last Name:ABD-ALMONUM
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 1:7322 BAY PKWY APT B5
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-6035
Mailing Address - Country:US
Mailing Address - Phone:917-808-5482
Mailing Address - Fax:
Practice Address - Street 1:7322 BAY PKWY APT B5
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-6035
Practice Address - Country:US
Practice Address - Phone:917-808-5482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-22
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039721225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist