MEDICARE: AMERICAN MEDICAL COMPANY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center	040926	NY

General Provider Information

NPI Number	:	1053859207
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN MEDICAL COMPANY

Provider Business Mailing Address
First Line	:	260 MIDDLE COUNTRY RD
Second Line	:	BUILDING 3 SUIT 9A
City	:	SELDEN
State	:	NY
Zip	:	11784-2568
Country	:	US
Telephone Number	:	631-732-1600
Fax Number	:

Provider Business Practice Location Address
First Line	:	1671 W 10TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-1104
Country	:	US
Telephone Number	:	718-975-6793
Fax Number	:

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	MARIAM ABDELAZIM IBRAHIM
Credential	:	PT
Telephone Number	:	518-353-9379

Provider Enumeration Date	:	02/08/2017
Last Update Date	:	02/08/2017

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Directions to “AMERICAN MEDICAL COMPANY ” Practice Location

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