Provider Demographics
NPI:1639195993
Name:SEECOOMAR, LESLIE F (MD)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:F
Last Name:SEECOOMAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 W 68TH ST
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-6020
Mailing Address - Country:US
Mailing Address - Phone:212-217-9961
Mailing Address - Fax:212-842-0338
Practice Address - Street 1:60 W 68TH ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-6020
Practice Address - Country:US
Practice Address - Phone:212-217-9961
Practice Address - Fax:212-842-0338
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY195225-1207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY53N83NW071Medicare PIN
NYG88193Medicare UPIN