Provider Demographics
NPI:1447763982
Name:BUTTERFLY P.T., P.C.
Entity type:Organization
Organization Name:BUTTERFLY P.T., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHMOUD
Authorized Official - Middle Name:A
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:929-245-4053
Mailing Address - Street 1:63 73RD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-1903
Mailing Address - Country:US
Mailing Address - Phone:929-245-4053
Mailing Address - Fax:
Practice Address - Street 1:63 73RD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-1903
Practice Address - Country:US
Practice Address - Phone:929-245-4053
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-07
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037979225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty