Individual
DR. JEFFREY S SIDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
812 WOODBURY RD, WOODBURY, NY 11797-2501
(516) 935-1234
Mailing address
812 WOODBURY RD, WOODBURY, NY 11797-2501
(516) 935-1234
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
155874
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005850
GHI
NY
01
—
113026525
TAX ID#
NY
01
—
155874 01
WORKERS COMP
NY
Enumeration date
12/07/2006
Last updated
07/16/2013
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