Individual provider Active NPI

Atif Mohamed Abdou

  • Physical Therapist
  • Brooklyn, NY
National Provider Identifier
1467685446
Registry record updated Aug 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
577 79TH St
Brooklyn, NY 11209-3709
Phone
(718) 496-8296
NPI assigned
Aug 25, 2009
Sex
Male
Sole proprietor
Yes

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)
Enrolled

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NY Primary

Addresses

NPPES NPI Registry

Primary practice location

577 79TH St
Brooklyn, NY 11209-3709

Mailing address

577 79TH Street
Brooklyn, NY 11209
Phone (718) 496-8296

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 25, 2009.

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251158400000",
    "number": "1467685446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "577 79TH STREET",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11209",
            "telephone_number": "718-496-8296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "577 79TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112093709",
            "telephone_number": "718-496-8296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDOU",
        "first_name": "ATIF",
        "middle_name": "MOHAMED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-25",
        "last_updated": "2009-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2009; 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.