Provider Demographics
NPI:1649204181
Name:SEEBACHER, JAY ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:ROBERT
Last Name:SEEBACHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:24 SAW MILL RIVER RD
Mailing Address - Street 2:STE 206
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-1541
Mailing Address - Country:US
Mailing Address - Phone:914-631-7777
Mailing Address - Fax:914-631-0920
Practice Address - Street 1:24 SAW MILL RIVER RD
Practice Address - Street 2:STE 206
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-1541
Practice Address - Country:US
Practice Address - Phone:914-631-7777
Practice Address - Fax:914-631-0920
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY132609207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY708934Medicaid
NY70A171Medicare ID - Type Unspecified
NYB18754Medicare UPIN