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General NPI Number Information
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NPI Number | 1710252762
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Entity Type | Organization
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Legal Business Name | HEALTH TOWER PHYSICAL THERAPY P.C
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Dates
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Enumeration Date | 03/08/2012
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Last Update Date | 03/08/2012
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Provider Practice Location Address
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Address Line | 8402 4TH AVE APT # C8
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City | BROOKLYN
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State | NY
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Zip | 11209-4657
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Country | US
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Telephone | 347-866-5048
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Fax | 718-680-0236
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Provider Business Mailing Address
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Address Line | 8402 4TH AVE APT # C8
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City | BROOKLYN
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State | NY
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Zip | 11209-4657
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Country | US
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Telephone | 347-866-5048
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Fax | 718-680-0236
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MR. EZZAT MOHAMED SHAABAN
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Credential | PHYSICAL THERAPIST
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Telephone | 347-866-5048
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1800X
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Taxonomy Name | Corporate Health Clinic/Center
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License Number | 017565
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License Number State | NY
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