Provider Demographics
NPI:1205374998
Name:BARRY SEIDMAN MD
Entity type:Organization
Organization Name:BARRY SEIDMAN MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-499-5227
Mailing Address - Street 1:5258 LINTON BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6540
Mailing Address - Country:US
Mailing Address - Phone:561-499-5227
Mailing Address - Fax:561-381-4920
Practice Address - Street 1:5258 LINTON BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6540
Practice Address - Country:US
Practice Address - Phone:561-499-5227
Practice Address - Fax:561-381-4920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-02
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0048901207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty