Healthcare Provider Details

I. General information

NPI: 1457292336
Provider Name (Legal Business Name): LAUREN ISABELLE SEIDMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 E 210TH ST
BRONX NY
10467-2401
US

IV. Provider business mailing address

111 E 210TH ST # 651
BRONX NY
10467-2401
US

V. Phone/Fax

Practice location:
  • Phone: 718-920-4417
  • Fax: 718-920-8375
Mailing address:
  • Phone: 718-920-4417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: