Provider Demographics
NPI:1780915421
Name:SIKORA, GERALDINE C (P T)
Entity type:Individual
Prefix:
First Name:GERALDINE
Middle Name:C
Last Name:SIKORA
Suffix:
Gender:F
Credentials:P T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 TERRACE AVE
Mailing Address - Street 2:APT. # E-3
Mailing Address - City:HASBROUCK HTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07604-2432
Mailing Address - Country:US
Mailing Address - Phone:347-399-2081
Mailing Address - Fax:
Practice Address - Street 1:2604 3RD AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-1199
Practice Address - Country:US
Practice Address - Phone:718-292-0100
Practice Address - Fax:718-866-0163
Is Sole Proprietor?:No
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031168225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY031168OtherLICENSE