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Individual

MRS. EILEEN SEIDELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
R. N., OTR/L

Contact information

Practice address
46 NEW MILL RD, SMITHTOWN, NY 11787-3342
(631) 366-1471
Mailing address
46 NEW MILL RD, SMITHTOWN, NY 11787-3342

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
410577-1
NY
225X00000X
Occupational Therapist
Primary
016296-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02813078
NY
Enumeration date
05/06/2008
Last updated
05/29/2012
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