Provider Demographics
NPI:1275578890
Name:SEIBT, ROBERT STEPHEN (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT STEPHEN
Middle Name:
Last Name:SEIBT
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 1:139 W 82ND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-5544
Mailing Address - Country:US
Mailing Address - Phone:212-877-1798
Mailing Address - Fax:973-736-8854
Practice Address - Street 1:25 CENTRAL PARK W
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-7253
Practice Address - Country:US
Practice Address - Phone:212-307-0089
Practice Address - Fax:212-541-9034
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-18
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY134571207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB14303Medicare UPIN
NY41A67Medicare ID - Type Unspecified
NJ466200Medicare ID - Type Unspecified