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General NPI Number Information
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NPI Number | 1740732858
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Entity Type | Individual
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Provider Name | RYAN CIESIELSKI DPT
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Gender | Male
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Dates
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Enumeration Date | 10/25/2016
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Last Update Date | 10/25/2016
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Provider Practice Location Address
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Address Line | 925 S SEMORAN BLVD 110A
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City | WINTER PARK
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State | FL
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Zip | 32792-5313
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Country | US
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Telephone | 800-521-9604
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Fax | 800-521-9608
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Provider Business Mailing Address
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Address Line | 616 CARDEZA AVE
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City | BRIELLE
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State | NJ
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Zip | 08730-1916
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Country | US
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Telephone | 732-816-1782
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | PT 31880
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA01412400
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License Number State | NJ
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