1013992569 NPI number — MRS. CONSTANCE SELIGMAN MSW

Table of content: MRS. CONSTANCE SELIGMAN MSW (NPI 1013992569)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013992569 NPI number — MRS. CONSTANCE SELIGMAN MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SELIGMAN
Provider First Name:
CONSTANCE
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013992569
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19 OAK PARK DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MORRISTOWN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07960-4615
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-993-9392
Provider Business Mailing Address Fax Number:
973-539-2205

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
248 COLUMBIA TPKE
Provider Second Line Business Practice Location Address:
SUITE 208 BLDG 3
Provider Business Practice Location Address City Name:
FLORHAM PARK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07932-1210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-539-2205
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/07/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  44SC00294200 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7158411 . This is a "AETNA PIN NUMBER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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