Provider Demographics
NPI:1780951335
Name:WASEF, AYMAN S (PT: DPT)
Entity type:Individual
Prefix:MR
First Name:AYMAN
Middle Name:S
Last Name:WASEF
Suffix:
Gender:M
Credentials:PT: DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80-46 KEW GARDENS ROAD
Mailing Address - Street 2:
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-1114
Mailing Address - Country:US
Mailing Address - Phone:718-261-1000
Mailing Address - Fax:718-261-0336
Practice Address - Street 1:80-46 KEW GARDENS ROAD
Practice Address - Street 2:
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-1114
Practice Address - Country:US
Practice Address - Phone:718-261-1000
Practice Address - Fax:718-261-0336
Is Sole Proprietor?:No
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist