Provider Demographics
NPI:1356435606
Name:SEIDEN, ROBERT J (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:SEIDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:286 E ROCKAWAY RD
Mailing Address - Street 2:
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-2753
Mailing Address - Country:US
Mailing Address - Phone:516-569-3838
Mailing Address - Fax:516-569-3839
Practice Address - Street 1:286 E ROCKAWAY RD
Practice Address - Street 2:
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-2753
Practice Address - Country:US
Practice Address - Phone:516-569-3838
Practice Address - Fax:516-569-3839
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2008-09-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY136325207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00824873Medicaid
NYC11878Medicare UPIN
NY69A831Medicare PIN