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General NPI Number Information
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NPI Number | 1548140379
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Entity Type | Individual
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Provider Name | MAHMOUD W ELZAYAT
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Gender | Male
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Dates
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Enumeration Date | 09/03/2025
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 225 RICHMOND HILL RD
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City | STATEN ISLAND
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State | NY
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Zip | 10314-5904
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Country | US
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Telephone | 718-979-5678
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Fax |
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Provider Business Mailing Address
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Address Line | 10 THRUSH MEWS
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City | NORTH BRUNSWICK
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State | NJ
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Zip | 08902-1223
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Country | US
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Telephone | 347-682-9650
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Fax |
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 46TA09258100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 011711
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License Number State | NY
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