Provider Demographics
NPI:1427292960
Name:ELKHOULY, AYMAN HASSAN (PT DPT)
Entity type:Individual
Prefix:DR
First Name:AYMAN
Middle Name:HASSAN
Last Name:ELKHOULY
Suffix:
Gender:M
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-4640
Mailing Address - Country:US
Mailing Address - Phone:718-714-9196
Mailing Address - Fax:718-372-6164
Practice Address - Street 1:462 LAKE ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-4640
Practice Address - Country:US
Practice Address - Phone:718-714-9196
Practice Address - Fax:718-372-6164
Is Sole Proprietor?:No
Enumeration Date:2009-04-28
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018447174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist