=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801722145
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | QUEENS ORTHOPPEDIC CARE PT PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/23/2026
-----------------------------------------------------
Last Update Date | 06/23/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6564 ELLWELL CRES
-----------------------------------------------------
City | REGO PARK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11374-5032
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-888-9138
-----------------------------------------------------
Fax | 347-888-9139
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6564 ELLWELL CRES
-----------------------------------------------------
City | REGO PARK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11374-5032
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | GROUP OWNER
-----------------------------------------------------
Name | MAHMOUD MOHAMED
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 929-575-2488
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2251X0800X
-----------------------------------------------------
Taxonomy Name | Orthopedic Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------