Provider Demographics
NPI:1902144041
Name:KAMAL, MOHAMMAD M (PT)
Entity Type:Individual
Prefix:MR
First Name:MOHAMMAD
Middle Name:M
Last Name:KAMAL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:401 HAMBURG TPKE
Mailing Address - Street 2:STE 204
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2154
Mailing Address - Country:US
Mailing Address - Phone:973-790-9010
Mailing Address - Fax:973-790-9050
Practice Address - Street 1:401 HAMBURG TPKE
Practice Address - Street 2:STE 204
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2154
Practice Address - Country:US
Practice Address - Phone:973-790-9010
Practice Address - Fax:973-790-9050
Is Sole Proprietor?:No
Enumeration Date:2013-01-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00188900208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation