Abdelrahman Mahmoud Eldeeb, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

011976 Issued in NY

Practice address

2052 Richmond Rd
Staten Island, NY 10306-2583

Phone

(718) 667-2190

Fax

(718) 667-7279

NPI assigned

May 15, 2019

Last updated

May 15, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1557878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1306402300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 NAUGHTON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103052227",
            "telephone_number": "646-944-0996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2052 RICHMOND RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062583",
            "telephone_number": "718-667-2190",
            "fax_number": "718-667-7279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELDEEB",
        "first_name": "ABDELRAHMAN",
        "middle_name": "MAHMOUD",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-15",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NY",
            "license": "011976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Khaled Elasmar, PT, DPT
• Linda Elassad, LCSW
• Amna Elayan
• Heidi Elbrolossey
• Adnan Elcharfa
• Colette Pauline Elder
• Jomol Eldho, RN
• Rana M Eldorr, M.S. SLP
• Waleed Eldorr
• Eldridge Dental Care P.C.

• Physical Therapy Assistant in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Physical Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.