Provider Demographics
NPI:1871846667
Name:EGE PT PC
Entity Type:Organization
Organization Name:EGE PT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:EHAB
Authorized Official - Middle Name:GHARIB,MORSY
Authorized Official - Last Name:EL-SAYED
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:718-333-9070
Mailing Address - Street 1:433 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-2335
Mailing Address - Country:US
Mailing Address - Phone:718-333-9070
Mailing Address - Fax:718-333-9060
Practice Address - Street 1:3049 OCEAN PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-8395
Practice Address - Country:US
Practice Address - Phone:718-333-9070
Practice Address - Fax:718-333-9060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-18
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026516252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency