MEDICARE: ASPIRE WELLNESS PHYSICAL THERAPY PC

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1073353264
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASPIRE WELLNESS PHYSICAL THERAPY PC

Provider Business Mailing Address
First Line	:	1723 ELM AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230
Country	:	US
Telephone Number	:	631-805-8268
Fax Number	:

Provider Business Practice Location Address
First Line	:	2215 79TH ST APT 2B
Second Line	:
City	:	EAST ELMHURST
State	:	NY
Zip	:	11370-2128
Country	:	US
Telephone Number	:	631-805-8268
Fax Number	:

Authorized Official
Title or Position	:	PRACTICE OWNER
Name	:	DR. MARAWAN AHMED
Credential	:
Telephone Number	:	631-805-8268

Provider Enumeration Date	:	05/28/2024
Last Update Date	:	07/09/2024

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