Provider Demographics
NPI:1467514463
Name:SEAWAY ORTHOPEDICS, PC
Entity Type:Organization
Organization Name:SEAWAY ORTHOPEDICS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BEDROS
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKIRTZIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-769-9908
Mailing Address - Street 1:271 ANDREWS ST
Mailing Address - Street 2:
Mailing Address - City:MASSENA
Mailing Address - State:NY
Mailing Address - Zip Code:13662-3401
Mailing Address - Country:US
Mailing Address - Phone:315-769-9908
Mailing Address - Fax:315-764-5430
Practice Address - Street 1:271 ANDREWS ST
Practice Address - Street 2:
Practice Address - City:MASSENA
Practice Address - State:NY
Practice Address - Zip Code:13662-3401
Practice Address - Country:US
Practice Address - Phone:315-769-9908
Practice Address - Fax:315-764-5430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY178450213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0276750001Medicare NSC