Provider Demographics
NPI:1013936368
Name:SEELEY, DAVID SCOTT (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SCOTT
Last Name:SEELEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 W 25TH ST
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-3800
Mailing Address - Country:US
Mailing Address - Phone:201-243-9800
Mailing Address - Fax:201-243-9898
Practice Address - Street 1:11 W 25TH ST
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-3800
Practice Address - Country:US
Practice Address - Phone:201-243-9800
Practice Address - Fax:201-243-9898
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00547500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ60017435OtherHORIZON NJ HEALTH
NJ1006431OtherASH
NJ1911799OtherUNITED HEALTHCARE
NJ607004400OtherOFFICE OF WORKERS COMP
NJ8274100Medicaid
NJ2362096OtherAETNA
NJ780215654649460OtherHORIZON BC/BS
NJX7C79OtherWELL CHOICE
NJ9719027OtherCIGNA
NJ5805726OtherGHI
NJP1314472OtherOXFORD
NJ780215654649460OtherHORIZON BC/BS
NJ028576Medicare ID - Type Unspecified