Provider Demographics
NPI:1689184251
Name:ZEWAR, BASMA TAHER (PT)
Entity Type:Individual
Prefix:
First Name:BASMA
Middle Name:TAHER
Last Name:ZEWAR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1423 BEDFORD AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-3840
Mailing Address - Country:US
Mailing Address - Phone:347-396-3599
Mailing Address - Fax:347-396-3153
Practice Address - Street 1:1423 BEDFORD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-3840
Practice Address - Country:US
Practice Address - Phone:347-396-3599
Practice Address - Fax:347-396-3153
Is Sole Proprietor?:No
Enumeration Date:2017-10-09
Last Update Date:2019-02-14
Deactivation Date:2018-05-18
Deactivation Code:
Reactivation Date:2018-10-11
Provider Licenses
StateLicense IDTaxonomies
NY040142225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist