Individual
MAMDOUH SAYED IBRAHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
221 COUNTY RD, CRESSKILL, NJ 07626-1605
(201) 567-9310
Mailing address
33 SUNSET AVE, BAYONNE, NJ 07002-2209
(201) 339-5185
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
QB1281
NJ
Other
Enumeration date
05/22/2007
Last updated
07/08/2007
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