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General NPI Number Information
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NPI Number | 1467721928
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Entity Type | Organization
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Legal Business Name | STUART NEIL SEIDMAN, MD, PC
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Dates
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Enumeration Date | 12/29/2011
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Last Update Date | 02/09/2012
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Provider Practice Location Address
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Address Line | 617 W END AVE 1B
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City | NEW YORK
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State | NY
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Zip | 10024-1607
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Country | US
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Telephone | 646-389-3683
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Fax | 212-202-4187
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Provider Business Mailing Address
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Address Line | 617 W END AVE 1B
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City | NEW YORK
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State | NY
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Zip | 10024-1607
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Country | US
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Telephone | 212-579-0339
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Fax | 212-202-4187
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STUART NEIL SEIDMAN
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Credential | MD
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Telephone | 646-389-3683
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 183145
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License Number State | NY
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