1265561203 NPI number — TERESA JANE SEYDEL MD

Table of content: JOAL R MILLER P.T. (NPI 1841270477)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265561203 NPI number — TERESA JANE SEYDEL MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SEYDEL
Provider First Name:
TERESA
Provider Middle Name:
JANE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ADDEO
Provider Other First Name:
TERESA
Provider Other Middle Name:
JANE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1265561203
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/04/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3421 CONCORD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YORK
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17402-9001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-851-1800
Provider Business Mailing Address Fax Number:
717-851-1810

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1010 PLYMOUTH RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YORK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17402-3864
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-851-1800
Provider Business Practice Location Address Fax Number:
717-851-1810
Provider Enumeration Date:
03/05/2007

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: 207Q00000X , with the licence number:  MD430509 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 261033 . This is a "UNISON-WMG WFM" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 9361058 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 109228 . This is a "GEISINGER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 212467 . This is a "UNISON-WMG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 20064757 . This is a "AMERIHEALTH MERCY-WMG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 261036 . This is a "UNISON-WMG VGFM" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 50069801 . This is a "CAPITAL BLUE CROSS-WMG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 210801 . This is a "JOHNS HOPKINS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2168117 . This is a "MAMSI-WMG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 50083203 . This is a "CAPITAL BC-WMG VGFM" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 296456 . This is a "UNISON-WMG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2848366000 . This is a "AMERIHEALTH 65PA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 50083182 . This is a "CAPITAL BC-WMG WFM" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1966917 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 101917283 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 897636 . This is a "CAREFIRST MD BCBS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: P008726 . This is a "GATEWAY-WMG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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