Provider Demographics
NPI:1154531671
Name:MAGNUM PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:MAGNUM PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:SAAD
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:718-645-2900
Mailing Address - Street 1:2263 E 15TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4316
Mailing Address - Country:US
Mailing Address - Phone:718-645-2900
Mailing Address - Fax:718-645-7288
Practice Address - Street 1:2263 E 15TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-4316
Practice Address - Country:US
Practice Address - Phone:718-645-2900
Practice Address - Fax:718-645-7288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ5W3X1Medicare ID - Type Unspecified