Basic Information
| Provider Information | |||||||||
| NPI: | 1164831061 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAMILTON | ||||||||
| FirstName: | FATIMA | ||||||||
| MiddleName: | ALICIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 962 E 54TH ST | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112341638 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9293682422 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2401 RESEARCH BLVD STE 109 | ||||||||
| Address2: | |||||||||
| City: | ROCKVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208503215 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3016575650 | ||||||||
| FaxNumber: | 3016575651 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2014 | ||||||||
| LastUpdateDate: | 10/25/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/25/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | 008954 | NY | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | 225200000X | A4010 | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.