Provider Demographics
NPI:1710332200
Name:PEAK DYNAMICS PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:PEAK DYNAMICS PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:NADY
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:929-444-5178
Mailing Address - Street 1:76 70TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-1114
Mailing Address - Country:US
Mailing Address - Phone:929-444-5178
Mailing Address - Fax:
Practice Address - Street 1:369 LEXINGTON AVE RM 12B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-6527
Practice Address - Country:US
Practice Address - Phone:929-444-5178
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-03
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034973-1261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy