Provider Demographics
NPI:1093819476
Name:SEIDMAN, NELSON (DC)
Entity Type:Individual
Prefix:DR
First Name:NELSON
Middle Name:
Last Name:SEIDMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 DOBBS FERRY ROAD DR. NELSON SEIDMAN
Mailing Address - Street 2:SUITE #200
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10607-1908
Mailing Address - Country:US
Mailing Address - Phone:914-582-2700
Mailing Address - Fax:888-687-3131
Practice Address - Street 1:180 SOUTH BROADWAY
Practice Address - Street 2:SUITE #202
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605
Practice Address - Country:US
Practice Address - Phone:914-582-2700
Practice Address - Fax:888-687-3131
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX000993-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX01721Medicare ID - Type Unspecified