Healthcare Provider Details

I. General information

NPI: 1487710323
Provider Name (Legal Business Name): ROSA M SEIJO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 05/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 MORRIS PARK AVE
BRONX NY
10461-1929
US

IV. Provider business mailing address

402 E 90TH ST APT. 5B
NEW YORK NY
10128-5119
US

V. Phone/Fax

Practice location:
  • Phone: 718-839-7280
  • Fax:
Mailing address:
  • Phone: 718-741-2500
  • Fax: 718-944-5408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number188613
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number188613
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: