Healthcare Provider Details

I. General information

NPI: 1386552453
Provider Name (Legal Business Name): GO RUN PHYSICAL THERAPY, P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

618 80TH ST APT 3R
BROOKLYN NY
11209-4022
US

IV. Provider business mailing address

618 80TH ST APT 3R
BROOKLYN NY
11209-4022
US

V. Phone/Fax

Practice location:
  • Phone: 716-239-7519
  • Fax:
Mailing address:
  • Phone: 716-239-7519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. MOHAMED EBADH
Title or Position: PHYSICAL THERAPIST
Credential:
Phone: 716-239-7519