Healthcare Provider Details

I. General information

NPI: 1437156510
Provider Name (Legal Business Name): KARIN SEIDEL O D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2005
Last Update Date: 08/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 BROOKLYN ST
MORRISVILLE VT
05661-8625
US

IV. Provider business mailing address

APT 1 833 BROOKLYN ST
MORRISVILLE VT
05661-8625
US

V. Phone/Fax

Practice location:
  • Phone: 802-888-5272
  • Fax: 802-888-5870
Mailing address:
  • Phone: 802-888-5272
  • Fax: 802-888-5870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number030-0000189
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: