Provider Demographics
NPI:1205908704
Name:PEYSER, SETH (CH)
Entity type:Individual
Prefix:
First Name:SETH
Middle Name:
Last Name:PEYSER
Suffix:
Gender:M
Credentials:CH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2534 RT 44 55
Mailing Address - Street 2:
Mailing Address - City:GARDINER
Mailing Address - State:NY
Mailing Address - Zip Code:12525
Mailing Address - Country:US
Mailing Address - Phone:845-255-3600
Mailing Address - Fax:
Practice Address - Street 1:2534 RT 44 55
Practice Address - Street 2:
Practice Address - City:GARDINER
Practice Address - State:NY
Practice Address - Zip Code:12525
Practice Address - Country:US
Practice Address - Phone:845-255-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5852111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX36151Medicare PIN