Provider Demographics
NPI:1164609608
Name:SEDA, EVELYN R (MD)
Entity Type:Individual
Prefix:DR
First Name:EVELYN
Middle Name:R
Last Name:SEDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:414 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07501-2105
Mailing Address - Country:US
Mailing Address - Phone:973-742-1761
Mailing Address - Fax:973-742-2033
Practice Address - Street 1:414 BROADWAY
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07501-2105
Practice Address - Country:US
Practice Address - Phone:973-742-1761
Practice Address - Fax:973-742-2033
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04605800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine