Healthcare Provider Details

I. General information

NPI: 1235712530
Provider Name (Legal Business Name): DORSA SEIMAA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2021
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 VALLEY ST
MAPLEWOOD NJ
07040-1388
US

IV. Provider business mailing address

515 VALLEY ST STE 203
MAPLEWOOD NJ
07040-4300
US

V. Phone/Fax

Practice location:
  • Phone: 908-663-2929
  • Fax: 908-219-6213
Mailing address:
  • Phone: 267-831-3043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberL8-0010492
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License NumberSP024403
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ01134100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: