Provider Demographics
NPI:1659513828
Name:ELZAYAT, WALEED AHMED (PT,DPT,CCI)
Entity Type:Individual
Prefix:DR
First Name:WALEED
Middle Name:AHMED
Last Name:ELZAYAT
Suffix:
Gender:M
Credentials:PT,DPT,CCI
Other - Prefix:DR
Other - First Name:WALEED
Other - Middle Name:A
Other - Last Name:ELZAYAT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DOCTOR OF PHYSICAL T
Mailing Address - Street 1:111 WINFIELD ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-3545
Mailing Address - Country:US
Mailing Address - Phone:646-645-3166
Mailing Address - Fax:718-979-1263
Practice Address - Street 1:111 WINFIELD ST
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-3545
Practice Address - Country:US
Practice Address - Phone:646-645-3166
Practice Address - Fax:718-979-1263
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-02
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY21306225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist