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General NPI Number Information
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NPI Number | 1548395726
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Entity Type | Organization
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Legal Business Name | UNIVERSAL PHYSICAL THERAPY,P.C.
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3250 WESTCHESTER AVE, SUITE LL5
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City | BRONX
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State | NY
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Zip | 10461-4577
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Country | US
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Telephone | 718-518-8040
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Fax | 718-518-8043
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Provider Business Mailing Address
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Address Line | 3250 WESTCHESTER AVE, SUITE LL5
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City | BRONX
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State | NY
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Zip | 10461-4577
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Country | US
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Telephone | 718-518-8040
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Fax | 718-518-8043
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MAMDOUH M ELDEEB
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Credential | PT
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Telephone | 718-518-8040
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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 | 011463-1
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License Number State | NY
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