Healthcare Provider Details

I. General information

NPI: 1124588710
Provider Name (Legal Business Name): TERRY SEETOE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2019
Last Update Date: 09/27/2022
Certification Date: 09/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 W 26TH ST FL 4
NEW YORK NY
10001-6975
US

IV. Provider business mailing address

160 W 26TH ST FL 4
NEW YORK NY
10001-6975
US

V. Phone/Fax

Practice location:
  • Phone: 212-924-2510
  • Fax:
Mailing address:
  • Phone: 212-924-2510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number318383
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: