Provider Demographics
NPI:1689716326
Name:SHALABY, YASSER H (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:YASSER
Middle Name:H
Last Name:SHALABY
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2640 HARWAY AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-5534
Mailing Address - Country:US
Mailing Address - Phone:718-522-2004
Mailing Address - Fax:
Practice Address - Street 1:78 LIVINGSTON ST
Practice Address - Street 2:5TH FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5043
Practice Address - Country:US
Practice Address - Phone:718-522-2004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017554174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist