MEDICARE: MASTER CARE INC.

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	252Y00000X	Early Intervention Provider Agency	017090	NY

General Provider Information

NPI Number	:	1679930432
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MASTER CARE INC.

Provider Business Mailing Address
First Line	:	650 71ST ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-1618
Country	:	US
Telephone Number	:	917-593-0193
Fax Number	:	718-238-3736

Provider Business Practice Location Address
First Line	:	650 71ST ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-1618
Country	:	US
Telephone Number	:	917-593-0193
Fax Number	:	718-238-3736

Authorized Official
Title or Position	:	PHYSICAL THERAPIST/PRESIDENT
Name	:	DR. HAMDY MOKHTAR SHALAN
Credential	:	PT
Telephone Number	:	917-593-0193

Provider Enumeration Date	:	01/25/2016
Last Update Date	:	01/25/2016

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