| Doctor Name: | MR. EVAN A SEIDEL |
| NPI Number: | 1053644799 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | 074263 |
| Business Practice Address: | 99 Main St Suite 205 Nyack, NY - 109603109 |
| Business Phone Number: | 8455488597 |
| Business Fax Number: | |
| Mailing Address: | 1 Ash Ct, NEW CITY |
| State: | NY |
| Postal Code: | 109563746 |
| Phone Number: | 8516721000 |
| Fax Number: | |
| NPI Enumeration Date: | 09/14/2009 |
| NPI Last Update Date: | 05/24/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 074263 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |