Provider Demographics
NPI:1295736247
Name:ELTOUNY, MAGDY K (PT)
Entity type:Individual
Prefix:
First Name:MAGDY
Middle Name:K
Last Name:ELTOUNY
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 1:2143 MORRIS AVE
Mailing Address - Street 2:#7
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083
Mailing Address - Country:US
Mailing Address - Phone:908-688-2077
Mailing Address - Fax:908-810-1789
Practice Address - Street 1:2143 MORRIS AVE
Practice Address - Street 2:#7
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083
Practice Address - Country:US
Practice Address - Phone:908-688-2077
Practice Address - Fax:908-810-1789
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00285600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
078845Medicare ID - Type Unspecified