# CRESTWATER PHYSICAL THERAPY PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083080576
- **Authorized official:** MRS. MAI ABDALLA DPT (OWNER)
- **Authorized official phone:** (718) 745-1313

## Contact information

- **Practice address:** 7129 5TH AVE, BROOKLYN, NY 11209-1678
- **Practice address phone:** (718) 745-1313
- **Practice address fax:** (718) 745-1333
- **Mailing address:** 7129 5TH AVE, BROOKLYN, NY 11209-1678
- **Mailing address phone:** (718) 745-1313
- **Mailing address fax:** (718) 745-1333

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 021464-1 | NY | Yes |

## Other

- **Enumeration date:** 08/19/2015
- **Last updated:** 08/19/2015