Organization
CRESTWATER PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MAI ABDALLA DPT (OWNER)
(718) 745-1313
Entity
Organization
Contact information
Practice address
7129 5TH AVE, BROOKLYN, NY 11209-1678
(718) 745-1313
(718) 745-1333
Mailing address
7129 5TH AVE, BROOKLYN, NY 11209-1678
(718) 745-1313
(718) 745-1333
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
021464-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021464-1
LISCENCE
NY
Enumeration date
08/19/2015
Last updated
08/19/2015
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