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General NPI Number Information
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NPI Number | 1841862349
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Entity Type | Organization
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Legal Business Name | CORE CARE PT PC
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Dates
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Enumeration Date | 07/14/2021
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Last Update Date | 07/14/2021
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Provider Practice Location Address
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Address Line | 8105 QUEENS BLVD # S2
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City | ELMHURST
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State | NY
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Zip | 11373-3750
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Country | US
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Telephone | 347-224-7777
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Fax |
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Provider Business Mailing Address
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Address Line | 8105 QUEENS BLVD # S2
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City | ELMHURST
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State | NY
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Zip | 11373-3750
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Country | US
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Telephone | 347-224-7777
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Fax |
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Authorized Official
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Title or Position | PT
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Name | MAHMOUD D MOHAMED
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Credential |
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Telephone | 929-575-2488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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