Mamdouh M Eldeeb, PT

Primary specialty

SpecialistTaxonomy code 174400000X

License

011463 Issued in NY

Practice address

3250 Westchester Ave
Suite LL5
Bronx, NY 10461-4500

Phone

(718) 518-8040

Fax

(718) 518-8043

NPI assigned

May 10, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2007

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Universal Physical Therapy,P.C.

  • Physical Therapy Clinic/Center
  • Bronx, NY
  • NPI 1548395726
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104876408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 FAITH LN",
            "city": "ARDSLEY",
            "state": "NY",
            "postal_code": "105022529",
            "telephone_number": "914-484-8210",
            "fax_number": "718-518-8043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 WESTCHESTER AVE",
            "address_2": "SUITE LL5",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104614500",
            "telephone_number": "718-518-8040",
            "fax_number": "718-518-8043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDEEB",
        "first_name": "MAMDOUH",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "011463",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Elbaum, MPH, RD, CDN, CDE
• Joshua Elbaz
• Yardane Elbaz
• Elise Marie Elbrecht, LCSW
• Adam Eldahan, FNP DNP
• Mohamed M. Hassib Eldefrawi, M.D., PH.D.
• Elder Pharmacy LLC
• Elder Psychological Solutions PC
• Gregory Allen Elder, M.D.
• Elderedge Inc.

• Specialist in Bronx, NY
• Providers in Bronx, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.