Healthcare Provider Details
I. General information
NPI: 1295449049
Provider Name (Legal Business Name): PHYSICAL CARE PT PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/06/2023
Last Update Date: 01/06/2023
Certification Date: 01/06/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10702R JAMAICA AVE
RICHMOND HILL NY
11418-2239
US
IV. Provider business mailing address
10702R JAMAICA AVE
RICHMOND HILL NY
11418-2239
US
V. Phone/Fax
- Phone: 718-395-2727
- Fax: 347-829-3888
- Phone: 718-395-2727
- Fax: 347-829-3888
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LAMIS
YAHIA
ABDELMAGEED
Title or Position: OWNER
Credential: PT
Phone: 347-525-0217