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General NPI Number Information
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NPI Number | 1821642109
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Entity Type | Organization
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Legal Business Name | SEGUIA & ELEAZAR PHYSICAL THERAPY PLLC
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Dates
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Enumeration Date | 07/25/2019
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Last Update Date | 07/25/2019
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Provider Practice Location Address
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Address Line | 403 E 91ST ST FL 4
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City | NEW YORK
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State | NY
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Zip | 10128-6800
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Country | US
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Telephone | 646-926-3481
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Fax | 646-390-2593
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Provider Business Mailing Address
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Address Line | 2335 STEINWAY ST # 1A
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City | ASTORIA
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State | NY
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Zip | 11105-1579
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Country | US
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Telephone | 646-926-3481
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RENA ELEAZAR
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Credential | PT, DPT
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Telephone | 646-926-3481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number |
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License Number State |
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