Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 135268 | NY |
NPI | 1013999697 |
---|---|
Provider Name | Dr. Mitchell Steven Seidman |
First Address | Brooklyn, NY 11235-8386 |
Second Address | Brooklyn, NY 11235-8386 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2005 |
Last Update Date | 26/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00434753 | (05) | NY |
A400023557 | MEDICARE PTAN (01) | NY |