Healthcare Provider Details

I. General information

NPI: 1962851790
Provider Name (Legal Business Name): SETH GREINER PT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2016
Last Update Date: 06/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 EISENHOWER DR
EAST QUOGUE NY
11942-4730
US

IV. Provider business mailing address

4 EISENHOWER DR
EAST QUOGUE NY
11942-4730
US

V. Phone/Fax

Practice location:
  • Phone: 617-319-6367
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: SETH GREINER
Title or Position: PHYSICAL THERAPIST
Credential:
Phone: 617-319-6367