Provider Demographics
NPI:1851637854
Name:AFIFI, MOHAMED YASSIN (DTP)
Entity Type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:YASSIN
Last Name:AFIFI
Suffix:
Gender:M
Credentials:DTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6802 RIDGE BLVD
Mailing Address - Street 2:APT. 4 M
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-5829
Mailing Address - Country:US
Mailing Address - Phone:646-341-7586
Mailing Address - Fax:
Practice Address - Street 1:4720 AVENUE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-3710
Practice Address - Country:US
Practice Address - Phone:646-341-7586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-19
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032816225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist