Provider Demographics
NPI:1285156562
Name:ALY, MOHAMED T (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MR
First Name:MOHAMED
Middle Name:T
Last Name:ALY
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 92ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-6208
Mailing Address - Country:US
Mailing Address - Phone:631-746-8750
Mailing Address - Fax:
Practice Address - Street 1:156 92ND ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-6208
Practice Address - Country:US
Practice Address - Phone:631-746-8750
Practice Address - Fax:631-746-8750
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-09
Last Update Date:2017-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037263225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist