Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | X005003 | NY |
N | 111NS0005X | Chiropractic Sports Physician | X005003 | NY |
NPI | 1316921661 |
---|---|
Provider Name | Dr. Richard Edward Seibert |
First Address | Merrick, NY 11566-3145 |
Second Address | Merrick, NY 11566-3145 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0014576 | GHI (01) | |
4304653 | AETNA (01) | |
563471 | UNITED HEALTH CARE (01) | |
8842419-003 | CIGNA (01) | |
P2752005 | OXFORD (01) | |
T53099 | (02) | NY |