Provider Demographics
NPI:1922475425
Name:SMILE FOR PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:SMILE FOR PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DOCTOR OF PHYSICAL THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:AHMED MANAA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANAA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:347-393-5248
Mailing Address - Street 1:11 BAY 34TH ST
Mailing Address - Street 2:APT. 2R
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-4210
Mailing Address - Country:US
Mailing Address - Phone:347-393-5248
Mailing Address - Fax:
Practice Address - Street 1:11 BAY 34TH ST
Practice Address - Street 2:APT. 2R
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-4210
Practice Address - Country:US
Practice Address - Phone:347-393-5248
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-01
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034892261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy