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General NPI Number Information
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NPI Number | 1811266869
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Entity Type | Organization
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Legal Business Name | ESSENTIAL REHAB PT PC
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Dates
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Enumeration Date | 12/21/2011
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Last Update Date | 12/21/2011
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Provider Practice Location Address
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Address Line | 17 W END AVE
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City | BROOKLYN
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State | NY
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Zip | 11235-4812
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Country | US
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Telephone | 718-484-8199
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Fax | 718-484-8197
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Provider Business Mailing Address
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Address Line | 46 CROFT PL
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City | STATEN ISLAND
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State | NY
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Zip | 10314-6508
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Country | US
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Telephone | 718-442-5089
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Fax | 718-442-5089
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MR. AHMED MAHMOUD ABDELHADY
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Credential | BACHLOR DEGREE
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Telephone | 917-816-7459
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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 | 030398
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License Number State | NY
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