Provider Demographics
NPI:1598072175
Name:ALI, MOHAMED ELSAYED (PT)
Entity Type:Individual
Prefix:MR
First Name:MOHAMED
Middle Name:ELSAYED
Last Name:ALI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:121 70TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-1129
Mailing Address - Country:US
Mailing Address - Phone:917-213-5081
Mailing Address - Fax:718-748-7110
Practice Address - Street 1:121 70TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-1129
Practice Address - Country:US
Practice Address - Phone:917-213-5081
Practice Address - Fax:718-748-7110
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-03
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025339225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist