Healthcare Provider Details

I. General information

NPI: 1639336670
Provider Name (Legal Business Name): ZALIVIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2008
Last Update Date: 05/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 PHILADELPHIA AVENUE SUITE2
NORTHERN CAMBRIA PA
15714-1166
US

IV. Provider business mailing address

1300 PHILADELPHIA AVENUE SUITE2
NORTHERN CAMBRIA PA
15714-1166
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. ERNEST J SEKERAK
Title or Position: PHYSICAL THERAPIST/OWNER
Credential: MPT, CSCS
Phone: 814-948-8220