Provider Demographics
NPI:1073314951
Name:SEAGREN, DANIEL JAY (PEER SPECIALIST)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:JAY
Last Name:SEAGREN
Suffix:
Gender:
Credentials:PEER SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-2403
Mailing Address - Country:US
Mailing Address - Phone:914-761-0600
Mailing Address - Fax:
Practice Address - Street 1:1 PARK PL
Practice Address - Street 2:
Practice Address - City:PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10566-3887
Practice Address - Country:US
Practice Address - Phone:914-737-7338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPS-5480175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist