Provider Demographics
NPI:1821710336
Name:SEAYAM, EMILY (RDO)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:SEAYAM
Suffix:
Gender:F
Credentials:RDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 FRANZONE DR
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01835-7118
Mailing Address - Country:US
Mailing Address - Phone:978-810-8964
Mailing Address - Fax:
Practice Address - Street 1:40 ENON ST STE 7
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-1168
Practice Address - Country:US
Practice Address - Phone:978-922-5996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6850156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician