MEDICARE: MR. AHMED MAHMOUD ELMANSY PT

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	016017	NY

General Provider Information

NPI Number	:	1801084850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. AHMED MAHMOUD ELMANSY PT

Provider Business Mailing Address
First Line	:	8523 FORT HAMILTON PKWY APT 3F
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-4822
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	:	10/03/2007
Last Update Date	:	12/30/2014

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