Provider Demographics
NPI:1740905116
Name:ABDELROHMAN, ALWALED YEHIA SR (PT)
Entity type:Individual
Prefix:DR
First Name:ALWALED
Middle Name:YEHIA
Last Name:ABDELROHMAN
Suffix:SR
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 1:411 MARSHALL ST
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07503-2961
Mailing Address - Country:US
Mailing Address - Phone:862-571-7805
Mailing Address - Fax:
Practice Address - Street 1:447 BAY RIDGE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-5973
Practice Address - Country:US
Practice Address - Phone:718-238-6162
Practice Address - Fax:718-333-5927
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-07
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049301225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist