Individual
MOUSTAFA AHMED FARAGALLAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2055 60TH ST APT 4, BROOKLYN, NY 11204-2434
(718) 331-6323
Mailing address
2055 60TH ST APT 4, BROOKLYN, NY 11204-2434
(718) 331-6323
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
014922
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014922
014922
NY
Enumeration date
04/29/2008
Last updated
04/29/2008
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