Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 0105132 | NY |
Y | 103T00000X | Psychologist | 0105132 | NY |
NPI | 1003970054 |
---|---|
Provider Name | Sean William Seibert |
First Address | Jamestown, NY 14701-5315 |
Second Address | Jamestown, NY 14701-5315 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00020913301 | UNIVERA (01) | |
000511085001 | BCBS (01) | NY |
01243856 | (05) | NY |
11305 | FIDELIS (01) | |
324244 | MHN (01) | |
6107105 | INDEPENDENT HEALTH (01) | |
6893537002 | VALUE OPTIONS (01) | |
725284 | BCBS (01) | PA |
R55969 | (02) |