Provider Demographics
NPI:1194798702
Name:WALDMAN, SETH A (MD)
Entity type:Individual
Prefix:MR
First Name:SETH
Middle Name:A
Last Name:WALDMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3500 SUNRISE HWY, BLDG 100
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GREAT RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:11739-1001
Mailing Address - Country:US
Mailing Address - Phone:631-907-2186
Mailing Address - Fax:312-013-1796
Practice Address - Street 1:535 E 70TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4872
Practice Address - Country:US
Practice Address - Phone:212-606-1686
Practice Address - Fax:212-774-2196
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2023-09-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY180684207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY180684OtherNY WORKERS COMPENSATION
F61408Medicare UPIN