Healthcare Provider Details

I. General information

NPI: 1700839784
Provider Name (Legal Business Name): DAVID A.N. SIEGEL, MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

271 W 125TH ST STE 211
NEW YORK NY
10027-4424
US

IV. Provider business mailing address

393 W END AVE APT 11F
NEW YORK NY
10024-6138
US

V. Phone/Fax

Practice location:
  • Phone: 917-493-9600
  • Fax: 917-493-2078
Mailing address:
  • Phone: 646-321-6249
  • Fax: 917-493-2078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number217196
License Number StateNY

VIII. Authorized Official

Name: DR. DAVID A.N. SIEGEL
Title or Position: PRESIDENT
Credential: MD
Phone: 917-493-9600