Provider Demographics
NPI:1629603873
Name:SEIDMAN, ALANA
Entity Type:Individual
Prefix:
First Name:ALANA
Middle Name:
Last Name:SEIDMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 LUCERNE CT
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-5119
Mailing Address - Country:US
Mailing Address - Phone:856-287-5292
Mailing Address - Fax:
Practice Address - Street 1:13 LUCERNE CT
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-5119
Practice Address - Country:US
Practice Address - Phone:856-287-5292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-09
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant