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General NPI Number Information
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NPI Number | 1265974042
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Entity Type | Organization
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Legal Business Name | NERMINE SHENODA
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Dates
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Enumeration Date | 11/10/2016
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Last Update Date | 11/10/2016
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Provider Practice Location Address
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Address Line | 1125 63RD STREET APT A6
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City | BROOKLYN
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State | NY
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Zip | 11219
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Country | US
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Telephone | 347-206-9177
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Fax |
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Provider Business Mailing Address
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Address Line | 1125 63RD ST APT A6
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City | BROOKLYN
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State | NY
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Zip | 11219-5254
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Country | US
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Telephone | 347-206-9177
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | NERMINE SAFWAT BEKHIT SHENODA
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Credential |
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Telephone | 347-206-9177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 0390181
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License Number State | NY
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