Becher Alah Dakkak, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

4006-19 Issued in WI

Practice address

1300 W Silver Spring Dr
Glendale, WI 53209-4415

Phone

(414) 228-8120

NPI assigned

Nov 6, 2023

Sex

Male

Sole proprietor

Yes

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": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1871366484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 E KYLE CT",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531547942",
            "telephone_number": "414-530-2858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W SILVER SPRING DR",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532094415",
            "telephone_number": "414-228-8120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAKKAK",
        "first_name": "BECHER",
        "middle_name": "ALAH",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "4006-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in Glendale, WI
• Providers in Glendale, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.