Healthcare Provider Details
I. General information
NPI: 1356405393
Provider Name (Legal Business Name): MICHAEL D SEIDNER, M.D.,FACOG, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/21/2006
Last Update Date: 07/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
385 PROSPECT AVE
HACKENSACK NJ
07601-2570
US
IV. Provider business mailing address
385 PROSPECT AVE
HACKENSACK NJ
07601-2570
US
V. Phone/Fax
- Phone: 201-488-1700
- Fax: 201-488-1704
- Phone: 201-488-1700
- Fax: 201-488-1704
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
MARITZA
PEREZ
Title or Position: OFFICE MANAGER
Credential:
Phone: 201-488-1700