Provider Demographics
NPI:1295863538
Name:PATHALIL JOSEPH, SEENA (BPT)
Entity Type:Individual
Prefix:MRS
First Name:SEENA
Middle Name:
Last Name:PATHALIL JOSEPH
Suffix:
Gender:F
Credentials:BPT
Other - Prefix:MRS
Other - First Name:SEENA
Other - Middle Name:
Other - Last Name:SYRBE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BPT
Mailing Address - Street 1:155 KENSINGTON CT
Mailing Address - Street 2:
Mailing Address - City:COPIAGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11726-4311
Mailing Address - Country:US
Mailing Address - Phone:631-384-8499
Mailing Address - Fax:
Practice Address - Street 1:155 KENSINGTON CT
Practice Address - Street 2:
Practice Address - City:COPIAGUE
Practice Address - State:NY
Practice Address - Zip Code:11726-4311
Practice Address - Country:US
Practice Address - Phone:631-384-8499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028131225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist