Healthcare Provider Details

I. General information

NPI: 1801690425
Provider Name (Legal Business Name): ISAAC SEELENFREUND
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2025
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 STATE ROUTE 208
MONROE NY
10950-1829
US

IV. Provider business mailing address

674 E MAIN ST
MIDDLETOWN NY
10940-2644
US

V. Phone/Fax

Practice location:
  • Phone: 845-782-5040
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number065700
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: