Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 016841 | NY |
N | 2251S0007X | Physical Therapist - Sports | 016841 | NY |
NPI | 1265551618 |
---|---|
Provider Name | Sabri B Bahlool |
First Address | Brooklyn, NY 11209-6004 |
Second Address | Brooklyn, NY 11209-6004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2007 |
Last Update Date | 08/06/2012 |