Provider Demographics
NPI:1801055728
Name:SEIDL, CORINNE MARIE (NP)
Entity type:Individual
Prefix:MRS
First Name:CORINNE
Middle Name:MARIE
Last Name:SEIDL
Suffix:
Gender:F
Credentials:NP
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Other - Credentials:
Mailing Address - Street 1:DEPARTMENT OF ORTHOPAEDICS HSC T 18 RM 020
Mailing Address - Street 2:UNIVERSITY HOSPITAL, SUNY AT STONY BROOK
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-0001
Mailing Address - Country:US
Mailing Address - Phone:631-444-7670
Mailing Address - Fax:631-444-7671
Practice Address - Street 1:14 TECHNOLOGY DR
Practice Address - Street 2:SUITE 11
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3472
Practice Address - Country:US
Practice Address - Phone:631-444-4233
Practice Address - Fax:631-444-4217
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF300752-1363LA2200X
FLARNP9204850363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health