Individual
DR. ERIC SCOTT SIEGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12 EAST WILLOW STREET, MILLBURN, NJ 07041-1417
(973) 376-8500
(973) 376-1820
Mailing address
12 EAST WILLOW STREET, MILLBURN, NJ 07041
(973) 376-8500
(973) 376-1820
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
25MA06884200
NJ
207N00000X
Dermatology Physician
MA68842
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
223694845
HORIZON BLUE CROSS BLUE SHIELD OF NEW JERSEY
NJ
01
—
2299713
AETNA GROUP ID
NJ
Enumeration date
06/17/2006
Last updated
08/25/2010
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