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NPI Code Detail

MEDICARE: DR. BOYD H SEIDENBERG MD

MEDICARE: DR. BOYD H SEIDENBERG MD
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
1207W00000XOphthalmology PhysicianMA022326NJ
2207W00000XOphthalmology Physician0907611NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1221923710OTHERNJTAX ID

General Provider Information

NPI Number : 1518992890
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BOYD H SEIDENBERG MD
Provider Business Mailing Address
First Line : 85 S MAPLE AVE
Second Line :
City : RIDGEWOOD
State : NJ
Zip : 07450-4561
Country : US
Telephone Number : 201-447-2700
Fax Number : 201-447-5775
Provider Business Practice Location Address
First Line : 85 S MAPLE AVE
Second Line :
City : RIDGEWOOD
State : NJ
Zip : 07450-4561
Country : US
Telephone Number : 201-447-2700
Fax Number : 201-447-5775
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2006
Last Update Date : 12/10/2010

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