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General NPI Number Information
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NPI Number | 1548764608
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Entity Type | Organization
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Legal Business Name | SAFWA CORP
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Dates
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Enumeration Date | 03/22/2018
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Last Update Date | 03/22/2018
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Provider Practice Location Address
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Address Line | 119 ROME AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10304-3148
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Country | US
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Telephone | 917-664-4256
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Fax | 347-587-8215
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Provider Business Mailing Address
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Address Line | 119 ROME AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10304-3148
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Country | US
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Telephone | 917-664-4256
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Fax | 347-587-8215
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Authorized Official
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Title or Position | DOCTOR OF PHYSICAL THERAPY
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Name | DR. AHMED BEKHET
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Credential | PHYSICAL THERAPY
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Telephone | 917-664-4256
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 018234
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License Number State | NY
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