Mahmoud Elkalyobi, PHYSICAL THERAPIST

Individual provider Active NPI Orthopedic Physical Therapist · Danbury, CT

NPI 1326437013 · NPPES record last updated Jan 18, 2015

Key facts

NPI
1326437013
Entity type
Individual (NPI type 1)
Primary specialty
Orthopedic Physical Therapist 2251X0800X
License
005491 (CT)
Practice address
19 2ND Ave
Danbury, CT 06810-5614
Phone
(203) 930-0539
NPI assigned
Jan 18, 2015
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CT

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20150312001931 CT Practitioner - Physical Therapist in Private Practice 1254657059 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
005491CTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
In-Home Physical Therapy Service LLC Orthopedic Current
since Nov 15, 2014
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 005491 CT Yes

Addresses

Primary practice location

19 2ND Ave
Danbury, CT 06810-5614

Mailing address

19 2ND Ave
Danbury, CT 06810-5614
Phone (203) 930-0539

Other providers in Danbury, CT

All providers in Danbury, CT · Orthopedic Physical Therapist in Connecticut

Sources for this page

Verify at the official NPI Registry.