Provider Demographics
NPI:1134188196
Name:SEEDOR, JOHN ARTHUR (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ARTHUR
Last Name:SEEDOR
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 1:310 E 14TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4201
Mailing Address - Country:US
Mailing Address - Phone:212-505-6550
Mailing Address - Fax:212-979-1772
Practice Address - Street 1:310 E 14TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4201
Practice Address - Country:US
Practice Address - Phone:212-505-6550
Practice Address - Fax:212-979-1772
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY150780207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0061631OtherGHI ID
NY170000126OtherPALMETTO ID
NY50044OtherCIGNA ID
NY56355OtherAETNA USHC
NY690439OtherVYTRA ID
NY09248POtherHIP ID
NY150780-C40OtherHEALTHFIRST
NY01413634Medicaid
NY4246217OtherAETNA
NYNS414OtherOXFORD ID
NY150780-C40OtherHEALTHFIRST
NYA97193Medicare UPIN
NY01413634Medicaid