Healthcare Provider Details

I. General information

NPI: 1275496259
Provider Name (Legal Business Name): MARIAM MAGDY TOMA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1623 KINGS HWY
BROOKLYN NY
11229-1209
US

IV. Provider business mailing address

1623 KINGS HWY
BROOKLYN NY
11229-1209
US

V. Phone/Fax

Practice location:
  • Phone: 929-273-7601
  • Fax:
Mailing address:
  • Phone: 929-273-7601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number009194
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: