MEDICARE: MS. CYNTHIA E. SEIDMAN R.D.

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	133V00000X	Registered Dietitian	000127-1	NY

General Provider Information

NPI Number	:	1386925824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CYNTHIA E. SEIDMAN R.D.

Provider Business Mailing Address
First Line	:	411 E 57TH ST
Second Line	:	APT. 15-E
City	:	NEW YORK
State	:	NY
Zip	:	10022-3066
Country	:	US
Telephone Number	:	212-308-6341
Fax Number	:

Provider Business Practice Location Address
First Line	:	411 E 57TH ST
Second Line	:	APT. 15-E
City	:	NEW YORK
State	:	NY
Zip	:	10022-3066
Country	:	US
Telephone Number	:	212-308-6341
Fax Number	:

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

Provider Enumeration Date	:	08/29/2011
Last Update Date	:	08/29/2011

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