Provider Demographics
NPI:1922721877
Name:SETH, ARIANNA
Entity Type:Individual
Prefix:
First Name:ARIANNA
Middle Name:
Last Name:SETH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 CLIFF RD
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON
Mailing Address - State:NY
Mailing Address - Zip Code:11777-1035
Mailing Address - Country:US
Mailing Address - Phone:516-708-7264
Mailing Address - Fax:
Practice Address - Street 1:112 CLIFF RD
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON
Practice Address - State:NY
Practice Address - Zip Code:11777-1035
Practice Address - Country:US
Practice Address - Phone:516-708-7264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY814680163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program