Provider Demographics
NPI:1861479438
Name:SEIDEN, LESLIE BARBARA (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:BARBARA
Last Name:SEIDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LESLIE
Other - Middle Name:BARBARA
Other - Last Name:GALLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10682 NORTHGREEN DR.
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33449-8047
Mailing Address - Country:US
Mailing Address - Phone:917-699-3561
Mailing Address - Fax:561-557-6140
Practice Address - Street 1:10682 NORTHGREEN DR.
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33449-8047
Practice Address - Country:US
Practice Address - Phone:917-699-3561
Practice Address - Fax:561-557-6140
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-27
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1046622084P0800X
PAMD051907L2084P0800X
FLME1316462084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB20438Medicare UPIN
NY959601Medicare ID - Type Unspecified