Provider Demographics
NPI:1508000647
Name:CEISLER, LAUREN BETH (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:BETH
Last Name:CEISLER
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 RIVERSIDE DR
Mailing Address - Street 2:APT 12F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-6555
Mailing Address - Country:US
Mailing Address - Phone:212-496-6630
Mailing Address - Fax:
Practice Address - Street 1:1775 BROADWAY
Practice Address - Street 2:SUITE 512
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1903
Practice Address - Country:US
Practice Address - Phone:212-757-3551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021142-1261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy