Active NPI
Mohamed Etiwy, DPT
- Physical Therapist
- Bronx, NY
National Provider Identifier
1013895796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 014842-01
- Practice address
- 1760 Grand Ave
Bronx, NY 10453-5545 - Phone
- (917) 819-8098
- NPI assigned
- Aug 22, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 014842-01 | NY | Primary |
Addresses
Primary practice location
1760 Grand Ave
Bronx, NY 10453-5545
Mailing address
8855 Bay Pkwy Apt 2E
Brooklyn, NY 11214-6422
Phone (917) 421-0172
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014842-01 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1755820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755820800000",
"number": "1013895796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8855 BAY PKWY APT 2E",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112146422",
"telephone_number": "917-421-0172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1760 GRAND AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104535545",
"telephone_number": "917-819-8098"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETIWY",
"first_name": "MOHAMED",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-08-22",
"last_updated": "2025-08-22",
"certification_date": "2025-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "014842-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.