Provider Demographics
NPI:1043229230
Name:SEDER, BRYAN J (MPT)
Entity Type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:J
Last Name:SEDER
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 RENEE CIR
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-4106
Mailing Address - Country:US
Mailing Address - Phone:215-327-1693
Mailing Address - Fax:215-754-0577
Practice Address - Street 1:1105 RENEE CIR
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-4106
Practice Address - Country:US
Practice Address - Phone:215-327-1693
Practice Address - Fax:215-754-0577
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT008966L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA072838Medicare ID - Type UnspecifiedSEDER PT MEDICARE #
PA054176R17Medicare ID - Type UnspecifiedBRYAN MC#