Individual
DR. AUDRA ROCHELLE SIEGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
696 DUTCHESS TPKE STE M, POUGHKEEPSIE, NY 12603-6429
(845) 464-0630
Mailing address
243 NORTH RD STE 304, POUGHKEEPSIE, NY 12601-1173
(845) 451-7251
(845) 471-7372
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
65 006034
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02754227
—
NY
01
—
10111279
CDPHP PIN/IDENTIFIER
—
01
—
1235164997
NPI GROUP ID
—
01
—
200053170
MVP HEALTHCARE GROUP ID
—
01
—
4148374
MVP HEALTHCARE PIN
—
01
—
65 006034
NYS PROFESSIONAL LICENSE
—
01
—
AS00573K10
BLUE CROSS BLUE SHIELD PIN/IDENTIFIER
—
Enumeration date
06/10/2005
Last updated
05/31/2022
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