Organization
PREMIER MEDICAL FOR SPORT & REHABILITATION, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AHMED E. ELEMAM M.D. (OWNER)
(718) 258-7203
Entity
Organization
Contact information
Practice address
11027 72ND DR, FOREST HILLS, NY 11375-5513
(718) 258-7203
(718) 258-7202
Mailing address
PO BOX 290707, BROOKLYN, NY 11229-0707
(718) 258-7203
(718) 258-7202
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
199870
NY
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
199870
NY
Other
Enumeration date
11/19/2009
Last updated
11/19/2009
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