Provider Demographics
NPI:1932117371
Name:SEIFERMAN, DOROTHY (APRN)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:
Last Name:SEIFERMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MIRIAM
Other - Middle Name:
Other - Last Name:SEIFERMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:271 FINCH AVE
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06451-2715
Mailing Address - Country:US
Mailing Address - Phone:203-237-8084
Mailing Address - Fax:203-639-1333
Practice Address - Street 1:271 FINCH AVE
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06451-2715
Practice Address - Country:US
Practice Address - Phone:203-237-8084
Practice Address - Fax:203-639-1333
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000967163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004160941Medicaid
CT004160941Medicaid