Provider Demographics
NPI:1144271917
Name:BRUM, SETH U (MD)
Entity type:Individual
Prefix:DR
First Name:SETH
Middle Name:U
Last Name:BRUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 VICTORY BLVD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-6623
Mailing Address - Country:US
Mailing Address - Phone:718-477-6900
Mailing Address - Fax:718-477-7862
Practice Address - Street 1:2315 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-6623
Practice Address - Country:US
Practice Address - Phone:718-477-6900
Practice Address - Fax:718-477-7862
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY201333207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY201333-A63OtherHEALTHFIRST
NY2594306OtherGHI PPO
NY0403773OtherEVERCARE
NY000000058061OtherGHI HMO
NY1P0310OtherHEALTHNET
NY159727OtherELDERPLAN
NY5749575OtherAETNA PPO
NYP846232OtherOXFORD
NY01752267Medicaid
NY1003110OtherAETNA HMO
NY000000058061OtherGHI HMO