Provider Demographics
NPI:1952431819
Name:GINIGER, SEYMOUR (PHD)
Entity Type:Individual
Prefix:DR
First Name:SEYMOUR
Middle Name:
Last Name:GINIGER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 71 YELLOWSTONE BLVD
Mailing Address - Street 2:APARTMENT 7H
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-2888
Mailing Address - Country:US
Mailing Address - Phone:718-544-2155
Mailing Address - Fax:718-544-7468
Practice Address - Street 1:102 30 QUEENS BLVD
Practice Address - Street 2:SUITE LC
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-3118
Practice Address - Country:US
Practice Address - Phone:718-595-0580
Practice Address - Fax:718-544-7468
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009502103TF0000X, 103TP0814X, 103T00000X, 106H00000X, 103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01577215Medicaid
R52682Medicare UPIN
NY01577215Medicaid