Provider Demographics
NPI:1962276105
Name:PYRAMID CARE PT PC
Entity type:Organization
Organization Name:PYRAMID CARE PT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:HABLAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-888-1727
Mailing Address - Street 1:10 VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-3017
Mailing Address - Country:US
Mailing Address - Phone:929-888-1727
Mailing Address - Fax:
Practice Address - Street 1:10 VISTA AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-3017
Practice Address - Country:US
Practice Address - Phone:929-888-1727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty