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General NPI Number Information
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NPI Number | 1255657276
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Entity Type | Individual
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Provider Name | MR. HOSSAM SIEFALLAH ABBAS SR.
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Gender | Male
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Dates
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Enumeration Date | 04/15/2010
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Last Update Date | 11/13/2015
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Provider Practice Location Address
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Address Line | 4730 59TH ST APT. 4A
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City | WOODSIDE
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State | NY
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Zip | 11377-5547
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Country | US
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Telephone | 347-822-9557
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Fax | 347-848-0640
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Provider Business Mailing Address
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Address Line | 4050 NOSTRAND AVE
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City | BROOKLYN
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State | NY
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Zip | 11235-2234
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Country | US
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Telephone | 718-450-7070
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Fax | 718-621-0777
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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 | 015774-1
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License Number State | NY
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