Healthcare Provider Details

I. General information

NPI: 1942684956
Provider Name (Legal Business Name): MR. YOSEF SEEWALD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2015
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 CREEK LN
BRISTOL RI
02809-2401
US

IV. Provider business mailing address

26 FIREMANS MEMORIAL DRIVE SUITE 115
POMONA NY
10970
US

V. Phone/Fax

Practice location:
  • Phone: 718-964-6161
  • Fax:
Mailing address:
  • Phone: 800-750-8616
  • Fax: 845-362-8474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number018860
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: