Provider Demographics
NPI:1700099652
Name:ZELTSER, RONY (PT)
Entity Type:Individual
Prefix:
First Name:RONY
Middle Name:
Last Name:ZELTSER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 OCEANA DR E
Mailing Address - Street 2:APT 5D
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6681
Mailing Address - Country:US
Mailing Address - Phone:917-653-5333
Mailing Address - Fax:718-676-5902
Practice Address - Street 1:105 OCEANA DR E
Practice Address - Street 2:APT 5D
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-6681
Practice Address - Country:US
Practice Address - Phone:917-653-5333
Practice Address - Fax:718-676-5902
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023983225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ12R4Q4PX1Medicare PIN
NYQ12R41Medicare ID - Type Unspecified