MEDICARE: DR. ESTHER SIEGEL EDD RN CS

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	364SP0809X	Adult Psychiatric/Mental Health Clinical Nurse Specialist	190104-1	NY

General Provider Information

NPI Number	:	1972656643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ESTHER SIEGEL EDD RN CS

Provider Business Mailing Address
First Line	:	2109 BROADWAY
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10023
Country	:	US
Telephone Number	:	212-691-1702
Fax Number	:

Provider Business Practice Location Address
First Line	:	2109 BROADWAY
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10023-2138
Country	:	US
Telephone Number	:	212-691-1702
Fax Number	:

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

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	08/16/2016

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