Provider Demographics
NPI:1982616991
Name:SEIBERT, KATHERINE (MD)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:SEIBERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1037 MAIN ST
Mailing Address - Street 2:HUDSON RIVER HEALTHCARE
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-2913
Mailing Address - Country:US
Mailing Address - Phone:845-794-2010
Mailing Address - Fax:845-794-4569
Practice Address - Street 1:23 LAKEWOOD AVE
Practice Address - Street 2:HUDSON RIVER HEALTHCARE
Practice Address - City:MONTICELLO
Practice Address - State:NY
Practice Address - Zip Code:12701
Practice Address - Country:US
Practice Address - Phone:845-794-2010
Practice Address - Fax:845-794-4569
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY133006207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00942118Medicaid
A400041292Medicare PIN
NY00942118Medicaid
B19726 NYMedicare UPIN
NY86D481Medicare ID - Type Unspecified