Provider Demographics
NPI:1427423045
Name:RWAN PT PC
Entity type:Organization
Organization Name:RWAN PT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPT
Authorized Official - Prefix:
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:MAHMOUD
Authorized Official - Last Name:ABDELHADY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:917-816-7459
Mailing Address - Street 1:46 CROFT PL
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-6508
Mailing Address - Country:US
Mailing Address - Phone:917-816-7459
Mailing Address - Fax:718-442-5089
Practice Address - Street 1:1752 FRANCIS LEWIS BLVD
Practice Address - Street 2:
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357
Practice Address - Country:US
Practice Address - Phone:917-816-7459
Practice Address - Fax:718-746-4963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-08
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty