Provider Demographics
NPI:1639605199
Name:SEEMUNGAL, STEFAN LIONEL (MD)
Entity Type:Individual
Prefix:MR
First Name:STEFAN
Middle Name:LIONEL
Last Name:SEEMUNGAL
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 1:2601 OCEAN PARKWAY
Mailing Address - Street 2:ROOM 4N98
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235
Mailing Address - Country:US
Mailing Address - Phone:718-616-3779
Mailing Address - Fax:
Practice Address - Street 1:2601 OCEAN PARKWAY
Practice Address - Street 2:ROOM 4N98
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235
Practice Address - Country:US
Practice Address - Phone:718-616-3779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-03
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program