Provider Demographics
NPI:1821642109
Name:SEGUIA & ELEAZAR PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:SEGUIA & ELEAZAR PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RENA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELEAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:646-926-3481
Mailing Address - Street 1:2335 STEINWAY ST # 1A
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105-1579
Mailing Address - Country:US
Mailing Address - Phone:646-926-3481
Mailing Address - Fax:
Practice Address - Street 1:403 E 91ST ST FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-6800
Practice Address - Country:US
Practice Address - Phone:646-926-3481
Practice Address - Fax:646-390-2593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-25
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Single Specialty