MEDICARE: MOHAMED ELDAMNHORY 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	041541-1	NY

General Provider Information

NPI Number	:	1922598556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHAMED ELDAMNHORY PT

Provider Business Mailing Address
First Line	:	2219 64TH ST APT E6
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-3223
Country	:	US
Telephone Number	:	347-247-4575
Fax Number	:

Provider Business Practice Location Address
First Line	:	2219 64TH ST APT E6
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-3223
Country	:	US
Telephone Number	:	347-247-4575
Fax Number	:

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

Provider Enumeration Date	:	05/18/2018
Last Update Date	:	05/18/2018

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