Provider Demographics
NPI:1043309636
Name:SETIAS, RONAH C (PT)
Entity Type:Individual
Prefix:
First Name:RONAH
Middle Name:C
Last Name:SETIAS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8201 37TH AVE
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-7011
Mailing Address - Country:US
Mailing Address - Phone:718-424-0303
Mailing Address - Fax:718-424-0920
Practice Address - Street 1:8201 37TH AVE
Practice Address - Street 2:4TH FLOOR
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7011
Practice Address - Country:US
Practice Address - Phone:718-424-0303
Practice Address - Fax:718-424-0920
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027378225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY027378OtherLICENSE