Provider Demographics
NPI:1265745236
Name:MEKHAEL, WAGDY WILLIAM (DPT)
Entity type:Individual
Prefix:DR
First Name:WAGDY
Middle Name:WILLIAM
Last Name:MEKHAEL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 BAY RIDGE PKWY
Mailing Address - Street 2:MANUAL THERAPY CENTER
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-2701
Mailing Address - Country:US
Mailing Address - Phone:718-680-5679
Mailing Address - Fax:
Practice Address - Street 1:431 BAY RIDGE PKWY
Practice Address - Street 2:MANUAL THERAPY CENTER
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-2701
Practice Address - Country:US
Practice Address - Phone:718-680-5679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-20
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032040225100000X, 2251N0400X, 2251P0200X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics