Provider Demographics
NPI:1194775247
Name:SEIDLER, DANIEL E (PT, MS)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:E
Last Name:SEIDLER
Suffix:
Gender:M
Credentials:PT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 8TH ST
Mailing Address - Street 2:APT 4R
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-7229
Mailing Address - Country:US
Mailing Address - Phone:917-268-4480
Mailing Address - Fax:855-554-6737
Practice Address - Street 1:243 8TH ST APT 4R
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-7229
Practice Address - Country:US
Practice Address - Phone:917-519-1351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2020-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL34468225100000X
UT11032834-2401225100000X
NY016390225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT3015283Medicaid
NY02487790Medicaid