Provider Demographics
NPI:1871479006
Name:SHAMAKH, MOHAMED AHMED KAMAL AHMED (PT)
Entity type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:AHMED KAMAL AHMED
Last Name:SHAMAKH
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 ROCKAWAY AVENUE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212
Mailing Address - Country:US
Mailing Address - Phone:347-217-3688
Mailing Address - Fax:718-975-7521
Practice Address - Street 1:400 ROCKAWAY AVENUE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212
Practice Address - Country:US
Practice Address - Phone:347-217-3688
Practice Address - Fax:718-975-7521
Is Sole Proprietor?:No
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041236-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist