Individual
SETH R DIVACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
153 W 11TH ST, NEW YORK, NY 10011-8305
(212) 604-7566
Mailing address
PO BOX 270, MASSAPEQUA PARK, NY 11762-0270
(631) 264-2035
(631) 264-1418
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
206903
NY
Other
Enumeration date
08/01/2006
Last updated
07/08/2007
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