Individual
LALITA SEETHARAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4117 MEDICAL CENTER DR, FAYETTEVILLE, NY 13066-6600
(315) 329-4968
(315) 329-4964
Mailing address
4117 MEDICAL CENTER DR, POD A, FAYETTEVILLE, NY 13066-6600
(315) 329-4968
(315) 329-4964
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
115936
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00466564
—
NY
Enumeration date
03/29/2006
Last updated
11/23/2011
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