Active NPI
Maryam Mohamed Abdullah, DPT
- Physical Therapist
- Brooklyn, NY
National Provider Identifier
1609469071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 046959
- Practice address
- 2579 Ocean Ave FL 3
Brooklyn, NY 11229-4552 - Phone
- (646) 780-0926
- NPI assigned
- Feb 17, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 046959 | NY | Primary |
Addresses
Primary practice location
2579 Ocean Ave FL 3
Brooklyn, NY 11229-4552
Mailing address
68 Vassar St
Staten Island, NY 10314-6004
Phone (347) 922-0128
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046959 | NY | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellness & Motion LLC | Current | Accepting new patients |
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.
-
- Early Intervention Provider Agency
- Parlin, NJ
- NPI 1184462392
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613520000000",
"number": "1609469071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "68 VASSAR ST",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103146004",
"telephone_number": "347-922-0128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2579 OCEAN AVE FL 3",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112294552",
"telephone_number": "646-780-0926"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABDULLAH",
"first_name": "MARYAM",
"middle_name": "MOHAMED",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-02-17",
"last_updated": "2021-02-17",
"certification_date": "2021-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "046959",
"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 Feb 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.