Provider Demographics
NPI:1578609269
Name:GOMAA, SAYED A (PT)
Entity Type:Individual
Prefix:
First Name:SAYED
Middle Name:A
Last Name:GOMAA
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 1:7004 3RD AVE
Mailing Address - Street 2:APT # 3
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-1307
Mailing Address - Country:US
Mailing Address - Phone:718-450-1377
Mailing Address - Fax:718-680-0915
Practice Address - Street 1:7004 3RD AVE
Practice Address - Street 2:APT # 3
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-1307
Practice Address - Country:US
Practice Address - Phone:718-450-1377
Practice Address - Fax:718-680-0915
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025553174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist