Provider Demographics
NPI:1609017144
Name:JOSE L. SELIGSON M.D. P.C.
Entity Type:Organization
Organization Name:JOSE L. SELIGSON M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:SELIGSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-482-1541
Mailing Address - Street 1:310 EAST SHORE RD.
Mailing Address - Street 2:SUITE 301
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-2432
Mailing Address - Country:US
Mailing Address - Phone:516-482-1541
Mailing Address - Fax:516-944-5231
Practice Address - Street 1:310 EAST SHORE RD.
Practice Address - Street 2:SUITE 301
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11023-2432
Practice Address - Country:US
Practice Address - Phone:516-482-1541
Practice Address - Fax:516-944-5231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-12
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1293372084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100000904Medicare PIN
NY1609017144Medicare PIN
NYO8A381Medicare PIN
NYA400008321Medicare PIN