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General NPI Number Information
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NPI Number | 1235556564
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Entity Type | Individual
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Provider Name | MARIAM MOHAMEDI
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Gender | Female
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Dates
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Enumeration Date | 03/25/2014
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Last Update Date | 03/25/2014
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Provider Practice Location Address
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Address Line | 139 CENTRE ST SUITE NO-PH 106/818
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City | NEW YORK
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State | NY
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Zip | 10013-4552
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Country | US
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Telephone | 212-343-8828
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Fax | 212-343-8829
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Provider Business Mailing Address
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Address Line | 6960 138TH ST APT B
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City | FLUSHING
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State | NY
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Zip | 11367-1632
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Country | US
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Telephone | 212-343-8828
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Fax | 212-343-8829
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 037274
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License Number State | NY
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