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NPI Code Detail

MEDICARE: MOHAMED HAMMAM PT,DPT

MEDICARE: MOHAMED HAMMAM PT,DPT
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
1225100000XPhysical Therapist048912NY

General Provider Information

NPI Number : 1841918240
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOHAMED HAMMAM PT,DPT
Provider Business Mailing Address
First Line : 981 US HIGHWAY 22 FL 2
Second Line :
City : BRIDGEWATER
State : NJ
Zip : 08807-2946
Country : US
Telephone Number : 201-801-7141
Fax Number :
Provider Business Practice Location Address
First Line : 1351 FOREST AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10302-2049
Country : US
Telephone Number : 718-390-0060
Fax Number : 718-390-0067
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2022
Last Update Date : 08/22/2022

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