MEDICARE: DR. DONALD J. SEILER OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OA 04197	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2095103	OTHER		AETNA
2	144687	OTHER		COLE VISION

General Provider Information

NPI Number	:	1114911476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD J. SEILER OD

Provider Business Mailing Address
First Line	:	323 SPRINGFIELD AVE
Second Line	:
City	:	SUMMIT
State	:	NJ
Zip	:	07901-3626
Country	:	US
Telephone Number	:	908-918-0377
Fax Number	:	908-918-0109

Provider Business Practice Location Address
First Line	:	323 SPRINGFIELD AVE
Second Line	:
City	:	SUMMIT
State	:	NJ
Zip	:	07901-3626
Country	:	US
Telephone Number	:	908-918-0377
Fax Number	:	908-918-0109

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2005
Last Update Date	:	10/22/2019

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Directions to “ DR. DONALD J. SEILER OD” Practice Location

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