Provider Demographics
NPI:1295084788
Name:ALAIDY, NAGAH A (PT)
Entity type:Individual
Prefix:
First Name:NAGAH
Middle Name:A
Last Name:ALAIDY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3728 75TH ST
Mailing Address - Street 2:BASEMENT
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-6426
Mailing Address - Country:US
Mailing Address - Phone:718-205-7710
Mailing Address - Fax:718-205-7730
Practice Address - Street 1:3728 75TH ST
Practice Address - Street 2:BASEMENT
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6426
Practice Address - Country:US
Practice Address - Phone:718-205-7710
Practice Address - Fax:718-205-7730
Is Sole Proprietor?:No
Enumeration Date:2012-08-30
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018475225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist