Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | X5935-1 | NY |
NPI | 1245303759 |
---|---|
Provider Name | Dr. Seth L. Berrin |
First Address | Glen Head, NY 11545-3309 |
Second Address | Hicksville, NY 11801-3508 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T93391 | (02) | NY |