Provider Demographics
NPI:1629130794
Name:SEKIRIN, ALEX (MPT, ACSM-HFS)
Entity Type:Individual
Prefix:MR
First Name:ALEX
Middle Name:
Last Name:SEKIRIN
Suffix:
Gender:M
Credentials:MPT, ACSM-HFS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8201 4 TH AVENUE
Mailing Address - Street 2:APT#5G
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209
Mailing Address - Country:US
Mailing Address - Phone:917-848-3858
Mailing Address - Fax:
Practice Address - Street 1:1000 ROUTE 9 NORTH
Practice Address - Street 2:SUITE 202
Practice Address - City:WOODBRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07095
Practice Address - Country:US
Practice Address - Phone:732-750-4900
Practice Address - Fax:732-750-4902
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21787225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD88843701OtherMD CAREFIRST
DCH853 0002OtherCAREFIRST OF DC
MD7546810OtherAETNA