Healthcare Provider Details

I. General information

NPI: 1598679128
Provider Name (Legal Business Name): HEALTHY CORE PT PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4645 WHITE PLAINS RD
BRONX NY
10470-1612
US

IV. Provider business mailing address

POBOX 61267
STATEN ISLAND NY
10306-9997
US

V. Phone/Fax

Practice location:
  • Phone: 718-231-7970
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MAHMOUD SOLOMA
Title or Position: PRESIDENT
Credential: DPT
Phone: 929-502-8523