Provider Demographics
NPI:1215311733
Name:SEAH, TRACE
Entity type:Individual
Prefix:MRS
First Name:TRACE
Middle Name:
Last Name:SEAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 PURPLE HEART WAY
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:NY
Mailing Address - Zip Code:12549-1632
Mailing Address - Country:US
Mailing Address - Phone:845-598-4229
Mailing Address - Fax:
Practice Address - Street 1:8 PURPLE HEART WAY
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:NY
Practice Address - Zip Code:12549-1632
Practice Address - Country:US
Practice Address - Phone:845-598-4229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-14
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY319335164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse