Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | F403262 | NY |
NPI | 1023669348 |
---|---|
Provider Name | Michele Jean Seid |
First Address | Central Islip, NY 11722-4172 |
Second Address | Central Islip, NY 11722-4172 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2019 |
Last Update Date | 09/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
495669-1 | REGISTERED NURSE (01) | NY |
495669-1 | REGISTERED NURSE LICENSE (01) | NY |