MEDICARE: MICHAEL A. SEITZ

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	1223G0001X	General Practice Dentistry	032517-1	NY

General Provider Information

NPI Number	:	1386691590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL A. SEITZ

Provider Business Mailing Address
First Line	:	PO BOX 445
Second Line	:
City	:	CORNWALL ON HUDSON
State	:	NY
Zip	:	12520-0445
Country	:	US
Telephone Number	:	845-534-2100
Fax Number	:	845-534-4507

Provider Business Practice Location Address
First Line	:	255 HUDSON ST
Second Line	:
City	:	CORNWALL ON HUDSON
State	:	NY
Zip	:	12520-1042
Country	:	US
Telephone Number	:	845-534-2100
Fax Number	:	845-534-4507

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

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	07/08/2007

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Directions to “ MICHAEL A. SEITZ ” Practice Location

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