Provider Demographics
NPI:1932268877
Name:SEIDMAN, DAVID A (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:SEIDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1421 3RD AVE
Mailing Address - Street 2:4TH FLR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-1802
Mailing Address - Country:US
Mailing Address - Phone:212-861-3700
Mailing Address - Fax:212-472-3086
Practice Address - Street 1:116-24 METROPOLITAN AVENUE
Practice Address - Street 2:2 FLR
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-1141
Practice Address - Country:US
Practice Address - Phone:718-805-9500
Practice Address - Fax:718-847-9457
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2020-12-07
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Provider Licenses
StateLicense IDTaxonomies
NY185533207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE87993Medicare UPIN
NY90F401Medicare PIN