Healthcare Provider Details

I. General information

NPI: 1215932355
Provider Name (Legal Business Name): ROBERT SANTI SEMINARA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

69 BAY RIDGE PKWY
BROOKLYN NY
11209-1924
US

IV. Provider business mailing address

69 BAY RIDGE PKWY
BROOKLYN NY
11209-1924
US

V. Phone/Fax

Practice location:
  • Phone: 718-921-1212
  • Fax: 718-921-3494
Mailing address:
  • Phone: 718-921-1212
  • Fax: 718-921-3494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number140146
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: