Provider Demographics
NPI:1548814049
Name:FOCUSED PHYSICAL THERAPY
Entity type:Organization
Organization Name:FOCUSED PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:CHAIM
Authorized Official - Last Name:HAMOU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-658-6353
Mailing Address - Street 1:10750 COLUMBIA PIKE STE 310
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-4453
Mailing Address - Country:US
Mailing Address - Phone:301-658-6353
Mailing Address - Fax:
Practice Address - Street 1:10750 COLUMBIA PIKE STE 310
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-4453
Practice Address - Country:US
Practice Address - Phone:301-658-6353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-01
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD424323400Medicaid