MEDICARE: MICHAEL K. SEIDENSTEIN, MD PA

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	174400000X	Specialist	25MA03333100	NJ

General Provider Information

NPI Number	:	1548228273
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL K. SEIDENSTEIN, MD PA

Provider Business Mailing Address
First Line	:	345 MAIN ST
Second Line	:
City	:	WEST ORANGE
State	:	NJ
Zip	:	07052-5700
Country	:	US
Telephone Number	:	973-736-8080
Fax Number	:	973-736-8471

Provider Business Practice Location Address
First Line	:	345 MAIN ST
Second Line	:
City	:	WEST ORANGE
State	:	NJ
Zip	:	07052-5700
Country	:	US
Telephone Number	:	973-736-8080
Fax Number	:	973-736-8471

Authorized Official
Title or Position	:	PRES. MD
Name	:	DR. MICHAEL K SEIDENSTEIN
Credential	:	MD
Telephone Number	:	973-736-8080

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	05/15/2014

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