Provider Demographics
NPI:1720280381
Name:CHAPERON, SEYMOUR JOHN (PT)
Entity Type:Individual
Prefix:MR
First Name:SEYMOUR
Middle Name:JOHN
Last Name:CHAPERON
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 1:21810 43RD AVE
Mailing Address - Street 2:APT 2C
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-3508
Mailing Address - Country:US
Mailing Address - Phone:347-804-6893
Mailing Address - Fax:
Practice Address - Street 1:21810 43RD AVE
Practice Address - Street 2:APT 2C
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-3508
Practice Address - Country:US
Practice Address - Phone:347-804-6893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022151-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist