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General NPI Number Information
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NPI Number | 1336405711
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Entity Type | Individual
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Provider Name | STEPHANIE NICOLE SEASLY MD
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Gender | Female
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Dates
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Enumeration Date | 04/10/2012
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 27 E 28TH ST FL 12
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City | NEW YORK
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State | NY
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Zip | 10016-7921
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Country | US
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Telephone | 877-456-2683
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9127
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City | METAIRIE
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State | LA
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Zip | 70055-9127
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Country | US
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Telephone |
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Fax | 301-703-2199
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101270381
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD.206792
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 71063
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License Number State | MN
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Taxonomy #4
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Taxonomy Code | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number | 0101270381
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | MD206792
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License Number State | LA
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