Provider Demographics
NPI:1437250206
Name:SEDDIO, NANCY C (PH D RNCS)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:C
Last Name:SEDDIO
Suffix:
Gender:F
Credentials:PH D RNCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 NIPPON AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312
Mailing Address - Country:US
Mailing Address - Phone:718-984-5444
Mailing Address - Fax:718-317-9538
Practice Address - Street 1:39 NIPPON AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312
Practice Address - Country:US
Practice Address - Phone:718-984-5444
Practice Address - Fax:718-317-9538
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY271709364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
P2982384OtherOXFORD
R03841OtherBCBS
157196OtherVALUE OPTIONS
202376OtherMANAGED HEALTH NETWORK
6169960OtherUNITED BEHAV HEALTH OF NY
NY6802342OtherGHI
7077960OtherCIGNA BEHAVIORAL HEALTH
162575OtherCOMPSYCH
NY17610POtherHI OF NY
S44520Medicare UPIN
NYR03841Medicare ID - Type Unspecified