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General NPI Number Information
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NPI Number | 1093683054
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Entity Type | Organization
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Legal Business Name | SEA HEALTH AND WELLNESS LLC
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Dates
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Enumeration Date | 10/29/2025
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 363 PROSPECT AVE FL 3
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City | HACKENSACK
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State | NJ
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Zip | 07601-2505
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Country | US
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Telephone | 201-696-6426
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1006
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City | MAYWOOD
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State | NJ
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Zip | 07607-7006
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Country | US
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Telephone | 201-696-6426
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SYED SIRAJUDDIN
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Credential | MD
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Telephone | 201-696-6426
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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