Provider Demographics
NPI:1649611468
Name:ALAM, RUHUL (DPT)
Entity type:Individual
Prefix:
First Name:RUHUL
Middle Name:
Last Name:ALAM
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 1:10528 77TH ST
Mailing Address - Street 2:
Mailing Address - City:OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11417-1011
Mailing Address - Country:US
Mailing Address - Phone:347-425-3843
Mailing Address - Fax:
Practice Address - Street 1:7425 GRAND AVE
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4126
Practice Address - Country:US
Practice Address - Phone:718-478-8400
Practice Address - Fax:718-478-8401
Is Sole Proprietor?:No
Enumeration Date:2013-07-09
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036267-12251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic