Organization
SI PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IBRAHIM ABDELFATAH (OWNER)
(718) 307-2905
Entity
Organization
Contact information
Practice address
119-60 METROPOLITAN AVE, KEW GARDENS, NY 11415
(718) 367-2905
Mailing address
119-60 METROPOLITAN AVE, KEW GARDENS, NY 11415
(718) 367-2905
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02119705
—
NY
Enumeration date
09/17/2020
Last updated
09/17/2020
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