MEDICARE: DAVID L SELIGMAN PTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	001492	CT

General Provider Information

NPI Number	:	1538567193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID L SELIGMAN PTA

Provider Business Mailing Address
First Line	:	PO BOX 5000
Second Line	:	267 GRANT STREET
City	:	BRIDGEPORT
State	:	CT
Zip	:	06610-0120
Country	:	US
Telephone Number	:	203-384-3000
Fax Number	:	203-384-4597

Provider Business Practice Location Address
First Line	:	267 GRANT STREET
Second Line	:
City	:	BRIDGEPORT
State	:	CT
Zip	:	06610-0120
Country	:	US
Telephone Number	:	203-384-3000
Fax Number	:	203-384-4597

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2014
Last Update Date	:	12/15/2014

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