Healthcare Provider Details

I. General information

NPI: 1063424349
Provider Name (Legal Business Name): ERNEST J SEKERAK MPT, CSCS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 05/14/2020
Certification Date: 05/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 PHILADELPHIA AVE SUITE 2
NORTHERN CAMBRIA PA
15714-1166
US

IV. Provider business mailing address

1055 SHOEMAKER ST
NANTY GLO PA
15943-1248
US

V. Phone/Fax

Practice location:
  • Phone: 814-948-8220
  • Fax: 814-948-8223
Mailing address:
  • Phone: 814-749-3355
  • Fax: 814-749-3362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT016823
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: