Provider Demographics
NPI:1992235626
Name:SEITZ, ROXANNE
Entity type:Individual
Prefix:
First Name:ROXANNE
Middle Name:
Last Name:SEITZ
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 1:256 WASHINGTON ST STE 2
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10553-1056
Mailing Address - Country:US
Mailing Address - Phone:914-613-0700
Mailing Address - Fax:914-664-8189
Practice Address - Street 1:256 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10553-1052
Practice Address - Country:US
Practice Address - Phone:914-920-3750
Practice Address - Fax:914-920-3750
Is Sole Proprietor?:No
Enumeration Date:2017-06-15
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY131839684Medicaid