Provider Demographics
NPI:1659857969
Name:ZAYED, TAREK KAMAL (DPT, PT)
Entity Type:Individual
Prefix:DR
First Name:TAREK
Middle Name:KAMAL
Last Name:ZAYED
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13238 59TH AVENU
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355
Mailing Address - Country:US
Mailing Address - Phone:347-396-3599
Mailing Address - Fax:347-396-3153
Practice Address - Street 1:13238 59TH AVENU
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355
Practice Address - Country:US
Practice Address - Phone:347-396-3599
Practice Address - Fax:347-396-3153
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2020-03-11
Deactivation Date:2019-03-08
Deactivation Code:
Reactivation Date:2020-03-11
Provider Licenses
StateLicense IDTaxonomies
NY039885225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist