Provider Demographics
NPI:1629449327
Name:ABDELAAL, AHMED ABDELAAL (PT)
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:ABDELAAL
Last Name:ABDELAAL
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 1:401 95TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-7486
Mailing Address - Country:US
Mailing Address - Phone:833-444-4399
Mailing Address - Fax:347-772-3424
Practice Address - Street 1:9433 5TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-1120
Practice Address - Country:US
Practice Address - Phone:833-444-4399
Practice Address - Fax:347-772-3424
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-07
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037637225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist