Healthcare Provider Details

I. General information

NPI: 1710095427
Provider Name (Legal Business Name): ERIC ARNOLD SEYBOLD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 03/23/2021
Certification Date: 03/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 PENNSYLVANIA AVENUE ORTHOPEDIC ASSOCIATES
BINGHAMTON NY
13903
US

IV. Provider business mailing address

65 PENNSYLVANIA AVE ORTHOPEDIC ASSOCIATES
BINGHAMTON NY
13903
US

V. Phone/Fax

Practice location:
  • Phone: 607-723-5393
  • Fax: 607-771-0803
Mailing address:
  • Phone: 607-723-5393
  • Fax: 607-771-0803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number209065
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number209065
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: