1215354592 NPI number — DR. ABDELHALIM ZAGHLOUL NADA PT, DPT, PHD.

Table of content: DR. ABDELHALIM ZAGHLOUL NADA PT, DPT, PHD. (NPI 1215354592)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215354592 NPI number — DR. ABDELHALIM ZAGHLOUL NADA PT, DPT, PHD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NADA
Provider First Name:
ABDELHALIM
Provider Middle Name:
ZAGHLOUL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PT, DPT, PHD.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215354592
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/25/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
427 BOARDWAY SUITE #3
Provider Second Line Business Mailing Address:
MOUNTAIN PHYSICAL THERAPY
Provider Business Mailing Address City Name:
MONTICELLO
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-796-2470
Provider Business Mailing Address Fax Number:
845-796-1420

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
427 BOARDWAY, SUITE #3
Provider Second Line Business Practice Location Address:
MOUNTAIN PHYSICAL THERAPY
Provider Business Practice Location Address City Name:
MONTICELLO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-796-2470
Provider Business Practice Location Address Fax Number:
845-796-1420
Provider Enumeration Date:
03/25/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  034785 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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