Provider Demographics
NPI:1588710529
Name:SIEBENECK, AARON J (DPM)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:J
Last Name:SIEBENECK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:6 WELLNESS WAY STE 201
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2156
Mailing Address - Country:US
Mailing Address - Phone:518-782-3700
Mailing Address - Fax:518-782-3799
Practice Address - Street 1:6 WELLNESS WAY STE 105
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-2156
Practice Address - Country:US
Practice Address - Phone:518-713-5340
Practice Address - Fax:518-782-3741
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYN005875213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU90715Medicare UPIN
NYDD1485Medicare PIN