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General NPI Number Information
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NPI Number | 1306136239
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Entity Type | Individual
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Provider Name | SHARI DIANA SEINUK-ROSS MD
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Gender | Female
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Dates
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Enumeration Date | 04/12/2011
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Last Update Date | 09/13/2022
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Provider Practice Location Address
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Address Line | 900 NORTHERN BLVD STE 260
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City | GREAT NECK
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State | NY
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Zip | 11021-5302
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Country | US
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Telephone | 516-916-4099
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Fax |
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Provider Business Mailing Address
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Address Line | 900 NORTHERN BLVD STE 260
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City | GREAT NECK
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State | NY
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Zip | 11021-5302
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Country | US
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Telephone | 516-916-4099
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 271814
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License Number State | NY
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