Provider Demographics
NPI:1245303759
Name:BERRIN, SETH L (DC)
Entity type:Individual
Prefix:DR
First Name:SETH
Middle Name:L
Last Name:BERRIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:SETH
Other - Middle Name:L
Other - Last Name:BERRIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:163 BROOKVILLE RD
Mailing Address - Street 2:
Mailing Address - City:GLEN HEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11545-3309
Mailing Address - Country:US
Mailing Address - Phone:516-978-2591
Mailing Address - Fax:516-932-1475
Practice Address - Street 1:372 S OYSTER BAY RD
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-3508
Practice Address - Country:US
Practice Address - Phone:516-931-0938
Practice Address - Fax:516-932-1475
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX5935-1111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT93391Medicare UPIN
NYX39921Medicare ID - Type Unspecified