Shady Khairy Iskander Yassa
Physical Therapist in Ridgewood, NY. Individual provider (NPI-1).
NPI number1669996385
StatusActive
Last updated in NPPESAug 3, 2017
Details
- NPI
- 1669996385
- Entity type
- Individual (NPI-1)
- Name
- Shady Khairy Iskander Yassa
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 3, 2017
- Last updated
- Aug 3, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | – | – | Yes |
Practice location
1829 Putnam AveRidgewood, NY 11385-4247
Phone 718-337-1100
Mailing address
224 Beach 20th St Lowr LevelFar Rockaway, NY 11691-3618
Phone 718-337-1100 · Fax 718-337-1101
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