Provider Demographics
NPI:1841444130
Name:EL GOHARY, TAREK MOHAMED (PT)
Entity type:Individual
Prefix:
First Name:TAREK
Middle Name:MOHAMED
Last Name:EL GOHARY
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 1:638 92ND ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-3602
Mailing Address - Country:US
Mailing Address - Phone:347-645-7763
Mailing Address - Fax:718-491-9239
Practice Address - Street 1:638 92ND ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-3602
Practice Address - Country:US
Practice Address - Phone:347-645-7763
Practice Address - Fax:718-491-9239
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-12
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018282225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist