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General NPI Number Information
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NPI Number | 1194473546
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Entity Type | Organization
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Legal Business Name | EASY CARE PT PC
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Dates
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Enumeration Date | 03/15/2022
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Last Update Date | 03/15/2022
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Provider Practice Location Address
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Address Line | 12616 101ST AVE
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City | SOUTH RICHMOND HILL
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State | NY
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Zip | 11419-1506
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Country | US
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Telephone | 201-920-4076
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Fax |
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Provider Business Mailing Address
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Address Line | 12616 101ST AVE
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City | SOUTH RICHMOND HILL
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State | NY
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Zip | 11419-1506
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PT
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Name | HAZEM ABDELHAFEZ
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Credential |
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Telephone | 201-920-4076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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