Provider Demographics
NPI:1952739534
Name:MAHMUT, AYLIN (PT)
Entity Type:Individual
Prefix:
First Name:AYLIN
Middle Name:
Last Name:MAHMUT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:WOOD RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07075-1201
Mailing Address - Country:US
Mailing Address - Phone:732-665-6334
Mailing Address - Fax:732-637-8933
Practice Address - Street 1:253 VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:WOOD RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07075-1201
Practice Address - Country:US
Practice Address - Phone:732-665-6334
Practice Address - Fax:732-637-8933
Is Sole Proprietor?:No
Enumeration Date:2013-10-17
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036519225100000X
NJ40QA01539300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist