Healthcare Provider Details

I. General information

NPI: 1588384846
Provider Name (Legal Business Name): RAMY SHEHATA ELKOUMY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2022
Last Update Date: 12/14/2025
Certification Date: 12/14/2025
Deactivation Date: 04/06/2023
Reactivation Date: 01/10/2024

III. Provider practice location address

8327L 124TH PL
KEW GARDENS NY
11415-2703
US

IV. Provider business mailing address

107-02 R JAMAICA AVE
RICHMOND HILL NY
11418
US

V. Phone/Fax

Practice location:
  • Phone: 646-220-0266
  • Fax:
Mailing address:
  • Phone: 347-829-3890
  • Fax: 347-829-3888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number047477-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: