Provider Demographics
NPI:1467721928
Name:STUART NEIL SEIDMAN, MD, PC
Entity Type:Organization
Organization Name:STUART NEIL SEIDMAN, MD, PC
Other - Org Name:WEST END MEDICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:NEIL
Authorized Official - Last Name:SEIDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-389-3683
Mailing Address - Street 1:617 W END AVE
Mailing Address - Street 2:1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1607
Mailing Address - Country:US
Mailing Address - Phone:212-579-0339
Mailing Address - Fax:212-202-4187
Practice Address - Street 1:617 W END AVE
Practice Address - Street 2:1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1607
Practice Address - Country:US
Practice Address - Phone:646-389-3683
Practice Address - Fax:212-202-4187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-29
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1831452084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1841312527OtherNPI
NY091571Medicare UPIN