Provider Demographics
NPI:1952540536
Name:GAD, VICTOR FAIK ATTIA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:FAIK ATTIA
Last Name:GAD
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 1:3 EAST DR
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797-2102
Mailing Address - Country:US
Mailing Address - Phone:646-577-1054
Mailing Address - Fax:
Practice Address - Street 1:35 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-3061
Practice Address - Country:US
Practice Address - Phone:646-807-3422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-05
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026764225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist