Provider Demographics
NPI:1801339015
Name:SHENODA, NERMINE SAFWAT BEKHIT (PT)
Entity type:Individual
Prefix:
First Name:NERMINE
Middle Name:SAFWAT BEKHIT
Last Name:SHENODA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 AVENUE K
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-4904
Mailing Address - Country:US
Mailing Address - Phone:718-859-6786
Mailing Address - Fax:718-859-6783
Practice Address - Street 1:1908 AVENUE K
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-4904
Practice Address - Country:US
Practice Address - Phone:718-859-6786
Practice Address - Fax:718-859-6783
Is Sole Proprietor?:No
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039018-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist