Provider Demographics
NPI:1609096155
Name:SEAMAN, TRACIE MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:TRACIE
Middle Name:MARIE
Last Name:SEAMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:TRACIE
Other - Middle Name:MARIE
Other - Last Name:AMBROSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:30 NO UNION ROAD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-8125
Mailing Address - Country:US
Mailing Address - Phone:716-839-8000
Mailing Address - Fax:716-839-8009
Practice Address - Street 1:30 NO UNION ROAD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221
Practice Address - Country:US
Practice Address - Phone:716-839-8000
Practice Address - Fax:716-839-8009
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY2433621208000000X
NY243362-1172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No172V00000XOther Service ProvidersCommunity Health Worker