Provider Demographics
NPI:1629100987
Name:ATTYA, MOHAMED HASSAN ALI
Entity Type:Individual
Prefix:
First Name:MOHAMED
Middle Name:HASSAN ALI
Last Name:ATTYA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2542 CROPSEY AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-6604
Mailing Address - Country:US
Mailing Address - Phone:347-679-0209
Mailing Address - Fax:
Practice Address - Street 1:2542 CROPSEY AVE FL 3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-6604
Practice Address - Country:US
Practice Address - Phone:347-679-0209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027668225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist