Provider Demographics
NPI:1124336995
Name:ELHAMADANY, MOHAMED HAFAD (PT, PHD)
Entity type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:HAFAD
Last Name:ELHAMADANY
Suffix:
Gender:M
Credentials:PT, PHD
Other - Prefix:
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Mailing Address - Street 1:5433 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-8005
Mailing Address - Country:US
Mailing Address - Phone:646-549-8170
Mailing Address - Fax:718-745-1492
Practice Address - Street 1:530 OVINGTON AVE
Practice Address - Street 2:APT # 2R
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-1725
Practice Address - Country:US
Practice Address - Phone:646-549-8170
Practice Address - Fax:718-745-1492
Is Sole Proprietor?:No
Enumeration Date:2010-09-15
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ND22362251P0200X
NY032846-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1482541Medicaid