Provider Demographics
NPI:1841784378
Name:MOHAMED, IBRAHIM ZAKARIA
Entity Type:Individual
Prefix:
First Name:IBRAHIM
Middle Name:ZAKARIA
Last Name:MOHAMED
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3007 OCEAN PKWY APT 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-8053
Mailing Address - Country:US
Mailing Address - Phone:347-337-6994
Mailing Address - Fax:
Practice Address - Street 1:3007 OCEAN PKWY APT 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-8053
Practice Address - Country:US
Practice Address - Phone:347-337-6994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-18
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist