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General NPI Number Information
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NPI Number | 1811921802
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Entity Type | Organization
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Legal Business Name | BOYD H SEIDENBERG MDPA
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 85 S MAPLE AVE
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City | RIDGEWOOD
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State | NJ
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Zip | 07450-4561
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Country | US
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Telephone | 201-447-2700
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Fax | 201-447-5775
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Provider Business Mailing Address
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Address Line | 85 S MAPLE AVE
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City | RIDGEWOOD
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State | NJ
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Zip | 07450-4561
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Country | US
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Telephone | 201-447-2700
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Fax | 201-447-5775
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BOYD H SEIDENBERG
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Credential | MD
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Telephone | 201-447-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 0907611
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MA022326
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License Number State | NJ
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