Provider Demographics
NPI:1952431355
Name:SEUNGDAMRONG, AIMEE M (MD)
Entity Type:Individual
Prefix:DR
First Name:AIMEE
Middle Name:M
Last Name:SEUNGDAMRONG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 TERRACE AVE
Mailing Address - Street 2:
Mailing Address - City:HASBROUCK HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07604-1815
Mailing Address - Country:US
Mailing Address - Phone:201-288-6330
Mailing Address - Fax:201-288-6331
Practice Address - Street 1:214 TERRACE AVE
Practice Address - Street 2:
Practice Address - City:HASBROUCK HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07604-1815
Practice Address - Country:US
Practice Address - Phone:201-288-6330
Practice Address - Fax:201-288-6331
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07746200207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology