MEDICARE: USAMA ELSEBAIE ABO-DONIA PHYSICAL THERAPIST

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	015685-1	NY

General Provider Information

NPI Number	:	1417268905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	USAMA ELSEBAIE ABO-DONIA PHYSICAL THERAPIST

Provider Business Mailing Address
First Line	:	1461 BATH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11228-3818
Country	:	US
Telephone Number	:	718-450-7070
Fax Number	:	718-621-0777

Provider Business Practice Location Address
First Line	:	1461 BATH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11228-3818
Country	:	US
Telephone Number	:	718-450-7070
Fax Number	:	718-621-0777

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2010
Last Update Date	:	06/29/2010

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Directions to “ USAMA ELSEBAIE ABO-DONIA PHYSICAL THERAPIST” Practice Location

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