Provider Demographics
NPI:1689214371
Name:MAHMUT, BERFIN (PT, DPT, CLT)
Entity Type:Individual
Prefix:
First Name:BERFIN
Middle Name:
Last Name:MAHMUT
Suffix:
Gender:F
Credentials:PT, DPT, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 5TH AVE STE 1002
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3046
Mailing Address - Country:US
Mailing Address - Phone:212-255-6355
Mailing Address - Fax:
Practice Address - Street 1:89 5TH AVE STE 1002
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3046
Practice Address - Country:US
Practice Address - Phone:212-255-6355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-09
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044414-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist