Mamdouh Sayed Ibrahim, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

QB1281 Issued in NJ

Practice address

221 County Rd
Cresskill, NJ 07626-1605

Phone

(201) 567-9310

NPI assigned

May 22, 2007

Last updated

Jul 8, 2007By 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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437368669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 SUNSET AVE",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070022209",
            "telephone_number": "201-339-5185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 COUNTY RD",
            "city": "CRESSKILL",
            "state": "NJ",
            "postal_code": "076261605",
            "telephone_number": "201-567-9310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBRAHIM",
        "first_name": "MAMDOUH",
        "middle_name": "SAYED",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NJ",
            "license": "QB1281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Janine Ellen Hurley-Nicoll, LCSW
• I Connect Family Chiropractic LLC
• Hiromu Imaeda, D.M.D.
• Inner Light Therapy & Counseling, LLC
• Zohra Jamal, RPH
• JHL Dental LLC (Cresskill Dental)
• Enmanuel Jimenez, PT, DPT

• Physical Therapy Assistant in Cresskill, NJ
• Providers in Cresskill, NJ by specialty
• Physical Therapy Assistant in New Jersey

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.