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General NPI Number Information
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NPI Number | 1922475425
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Entity Type | Organization
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Legal Business Name | SMILE FOR PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 09/01/2015
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Last Update Date | 09/01/2015
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Provider Practice Location Address
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Address Line | 11 BAY 34TH ST APT. 2R
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City | BROOKLYN
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State | NY
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Zip | 11214-4210
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Country | US
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Telephone | 347-393-5248
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Fax |
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Provider Business Mailing Address
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Address Line | 11 BAY 34TH ST APT. 2R
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City | BROOKLYN
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State | NY
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Zip | 11214-4210
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Country | US
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Telephone | 347-393-5248
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Fax |
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Authorized Official
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Title or Position | OWNER / DOCTOR OF PHYSICAL THERAPY
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Name | AHMED MANAA MANAA
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Credential | DPT
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Telephone | 347-393-5248
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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 | 034892
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License Number State | NY
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