Provider Demographics
NPI:1730200262
Name:AHMED, HUSSIEN MOHAMED (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:HUSSIEN
Middle Name:MOHAMED
Last Name:AHMED
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:312 MCCLEAN AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-4457
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9711 3RD AVE STE 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-7717
Practice Address - Country:US
Practice Address - Phone:718-755-5367
Practice Address - Fax:888-908-8284
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY019278225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist