Provider Demographics
NPI:1922566231
Name:ABOUKHALIA, HESHAM MOHAMED ABDELSATAR SR (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:HESHAM
Middle Name:MOHAMED ABDELSATAR
Last Name:ABOUKHALIA
Suffix:SR
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
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Mailing Address - Street 1:147 BAY 26TH ST APT 1F
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-4924
Mailing Address - Country:US
Mailing Address - Phone:929-253-7628
Mailing Address - Fax:
Practice Address - Street 1:147 BAY 26TH ST APT 1F
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-4924
Practice Address - Country:US
Practice Address - Phone:929-253-7628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-05
Last Update Date:2019-03-05
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty