Provider Demographics
NPI:1285804443
Name:NORTHWAY PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:NORTHWAY PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HUSSEIN
Authorized Official - Middle Name:MAHMOUD
Authorized Official - Last Name:AHMAD
Authorized Official - Suffix:
Authorized Official - Credentials:PT MS
Authorized Official - Phone:917-549-0976
Mailing Address - Street 1:944 NORTH BROADWAY
Mailing Address - Street 2:SUITE G-02
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701
Mailing Address - Country:US
Mailing Address - Phone:914-375-5605
Mailing Address - Fax:914-375-5405
Practice Address - Street 1:944 NORTH BROADWAY
Practice Address - Street 2:SUITE G-02
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701
Practice Address - Country:US
Practice Address - Phone:914-375-5605
Practice Address - Fax:914-375-5405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024084225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty