Provider Demographics
NPI:1396103636
Name:SCHOENBLUM, CELINA BRACHA (PT DPT)
Entity type:Individual
Prefix:DR
First Name:CELINA
Middle Name:BRACHA
Last Name:SCHOENBLUM
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 SEAGIRT AVE
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-5619
Mailing Address - Country:US
Mailing Address - Phone:516-301-0157
Mailing Address - Fax:
Practice Address - Street 1:302 SEAGIRT AVE
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-5619
Practice Address - Country:US
Practice Address - Phone:516-301-0157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039667225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist