Provider Demographics
NPI:1851651293
Name:NASR, SAMEH MORCOS (MS PT)
Entity Type:Individual
Prefix:MR
First Name:SAMEH
Middle Name:MORCOS
Last Name:NASR
Suffix:
Gender:M
Credentials:MS PT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4014 W MONTE VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-7001
Mailing Address - Country:US
Mailing Address - Phone:516-406-4898
Mailing Address - Fax:
Practice Address - Street 1:432 S CHURCH ST
Practice Address - Street 2:ST MARY PHYSICAL THERAPY
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277
Practice Address - Country:US
Practice Address - Phone:516-406-4898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-18
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40211225100000X
TX1229050225100000X
NY027788225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist