Provider Demographics
NPI:1285668152
Name:DANIEL SEIDLER PHYSICAL THERAPY, PC
Entity Type:Organization
Organization Name:DANIEL SEIDLER PHYSICAL THERAPY, PC
Other - Org Name:WESTCHESTER SQUARE PHYSICAL THERAPY, PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:SEIDLER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:917-268-4480
Mailing Address - Street 1:243 8TH ST APT 4R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-7229
Mailing Address - Country:US
Mailing Address - Phone:917-268-4480
Mailing Address - Fax:885-554-6737
Practice Address - Street 1:243 8TH ST APT 4R
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-7229
Practice Address - Country:US
Practice Address - Phone:917-519-1351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02487790Medicaid
NY03228824Medicaid
NYWZT8J1OtherMEDICARE PTAN
UT3015284Medicaid
NY02652913Medicaid