Provider Demographics
NPI:1477507465
Name:SHIFRIN, SETH P (MD)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:P
Last Name:SHIFRIN
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:110 S BEDFORD RD
Mailing Address - Street 2:MOUNT KISCO MEDICAL GROUP, PC
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3446
Mailing Address - Country:US
Mailing Address - Phone:914-302-8493
Mailing Address - Fax:914-302-8323
Practice Address - Street 1:90 S BEDFORD RD
Practice Address - Street 2:MOUNT KISCO MEDICAL GROUP, PC
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3412
Practice Address - Country:US
Practice Address - Phone:914-241-1050
Practice Address - Fax:914-302-8323
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2016-06-29
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Provider Licenses
StateLicense IDTaxonomies
NY237628207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02818239Medicaid
NYA400023034Medicare PIN
NYA400023034Medicare PIN
NY02818239Medicaid