Provider Demographics
NPI:1770986135
Name:LEDERMAN, SETH (MD)
Entity type:Individual
Prefix:DR
First Name:SETH
Middle Name:
Last Name:LEDERMAN
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 1:166 E 96TH ST
Mailing Address - Street 2:APT. 17A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-2565
Mailing Address - Country:US
Mailing Address - Phone:212-644-2610
Mailing Address - Fax:212-923-5700
Practice Address - Street 1:166 E 96TH ST
Practice Address - Street 2:APT 17A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-2565
Practice Address - Country:US
Practice Address - Phone:212-644-2610
Practice Address - Fax:212-923-5700
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY161136-1207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology