MEDICARE: HOSSAMELDIEN ELKHOLY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	026887	NY

General Provider Information

NPI Number	:	1336479187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOSSAMELDIEN ELKHOLY

Provider Business Mailing Address
First Line	:	1922 63RD ST
Second Line	:	2ND FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11204-3051
Country	:	US
Telephone Number	:	347-374-3786
Fax Number	:

Provider Business Practice Location Address
First Line	:	1922 63RD ST
Second Line	:	2ND FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11204-3051
Country	:	US
Telephone Number	:	347-374-3786
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2009
Last Update Date	:	08/18/2011

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Directions to “ HOSSAMELDIEN ELKHOLY ” Practice Location

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