Provider Demographics
NPI:1013531128
Name:HENDAWI, ALBARAA
Entity Type:Individual
Prefix:
First Name:ALBARAA
Middle Name:
Last Name:HENDAWI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 BAY 29TH STREET
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:11214
Mailing Address - Country:US
Mailing Address - Phone:347-435-6293
Mailing Address - Fax:
Practice Address - Street 1:23-31 STEINWAY ST
Practice Address - Street 2:
Practice Address - City:QUEENS
Practice Address - State:NY
Practice Address - Zip Code:11103
Practice Address - Country:US
Practice Address - Phone:929-463-7104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-04
Last Update Date:2022-08-04
Deactivation Date:2022-01-18
Deactivation Code:
Reactivation Date:2022-08-04
Provider Licenses
StateLicense IDTaxonomies
NY044190225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist