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General NPI Number Information
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NPI Number | 1891144382
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Entity Type | Organization
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Legal Business Name | OUTREACH MANUAL PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 06/06/2016
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Last Update Date | 06/06/2016
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Provider Practice Location Address
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Address Line | 8881 24TH AVE FL 2
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City | BROOKLYN
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State | NY
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Zip | 11214-6501
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Country | US
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Telephone | 929-888-1727
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Fax |
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Provider Business Mailing Address
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Address Line | 8881 24TH AVE FL 2
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City | BROOKLYN
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State | NY
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Zip | 11214-6501
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Country | US
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Telephone | 929-888-1727
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Fax |
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Authorized Official
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Title or Position | DR
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Name | DR. MOHAMED H HABLAS
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Credential |
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Telephone | 929-888-1727
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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 | 037478
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License Number State | NY
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