MEDICARE: DR. MOHAMED YOUSEF ABOSHAMA P.T., D.P.T.

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	020123	NY

General Provider Information

NPI Number	:	1477678936
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHAMED YOUSEF ABOSHAMA P.T., D.P.T.

Provider Business Mailing Address
First Line	:	1756 RICHMOND AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-3902
Country	:	US
Telephone Number	:	718-370-3581
Fax Number	:	718-370-3852

Provider Business Practice Location Address
First Line	:	1756 RICHMOND AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-3902
Country	:	US
Telephone Number	:	718-370-3581
Fax Number	:	718-370-3852

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

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	07/09/2007

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