Healthcare Provider Details

I. General information

NPI: 1649018623
Provider Name (Legal Business Name): PAUL ADEL GHALY DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2024
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3318 ABIGAIL CT
NEW PORT RICHEY FL
34655-1993
US

IV. Provider business mailing address

3318 ABIGAIL CT
NEW PORT RICHEY FL
34655-1993
US

V. Phone/Fax

Practice location:
  • Phone: 504-496-6800
  • Fax:
Mailing address:
  • Phone: 504-496-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT41757
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: