Provider Demographics
NPI:1861447955
Name:SIEGEL, DAVID AN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:AN
Last Name:SIEGEL
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:PO BOX 4193
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01202-4193
Mailing Address - Country:US
Mailing Address - Phone:413-443-7799
Mailing Address - Fax:413-443-7662
Practice Address - Street 1:294 FIRST STREET
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201
Practice Address - Country:US
Practice Address - Phone:413-443-7799
Practice Address - Fax:413-443-7662
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2171962081P2900X
MA245337208VP0000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2799102OtherGHI
NY1000037102OtherAFFINITY HEALTH PLANS
NYP3611255OtherOXFORD
NY4C9164OtherHEATHNET
MA245337OtherMA LICENSE
NY9384662OtherPHCS
NY217196OtherWORKERS' COMPENSATION
NY3971993OtherAETNA HMO
NY7982471OtherAETNA PPO
NYH30032Medicare UPIN
NY2799102OtherGHI
NYP3611255OtherOXFORD