Provider Demographics
NPI:1639336670
Name:ZALIVIA LLC
Entity Type:Organization
Organization Name:ZALIVIA LLC
Other - Org Name:X-CEL PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:J
Authorized Official - Last Name:SEKERAK
Authorized Official - Suffix:
Authorized Official - Credentials:MPT, CSCS
Authorized Official - Phone:814-948-8220
Mailing Address - Street 1:1300 PHILADELPHIA AVENUE
Mailing Address - Street 2:SUITE2
Mailing Address - City:NORTHERN CAMBRIA
Mailing Address - State:PA
Mailing Address - Zip Code:15714-1166
Mailing Address - Country:US
Mailing Address - Phone:814-948-8220
Mailing Address - Fax:814-948-8223
Practice Address - Street 1:1300 PHILADELPHIA AVENUE
Practice Address - Street 2:SUITE2
Practice Address - City:NORTHERN CAMBRIA
Practice Address - State:PA
Practice Address - Zip Code:15714-1166
Practice Address - Country:US
Practice Address - Phone:814-948-8220
Practice Address - Fax:814-948-8223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-19
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT016823225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1013791760001Medicaid
PA1013791760001Medicaid