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General NPI Number Information
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NPI Number | 1578431086
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Entity Type | Organization
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Legal Business Name | LIFESTYLE REHABILITATION LLC
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Dates
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Enumeration Date | 10/27/2025
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 1384 BROADWAY RM 606
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City | NEW YORK
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State | NY
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Zip | 10018-6110
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Country | US
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Telephone | 631-896-3821
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Fax | 212-302-0153
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Provider Business Mailing Address
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Address Line | 56 MARTHA PL
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City | CHAPPAQUA
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State | NY
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Zip | 10514-3109
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Country | US
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Telephone | 631-896-3821
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Fax | 212-302-0153
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Authorized Official
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Title or Position | OWNER
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Name | MATTHEW SELTZER
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Credential | DPT
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Telephone | 631-896-3821
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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