Basic Information
| Provider Information | |||||||||
| NPI: | 1306988811 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SEYBURN | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | FRANKLIN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 FRANKLIN AVE | ||||||||
| Address2: | SUITE300 | ||||||||
| City: | GARDEN CITY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115302926 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5162486868 | ||||||||
| FaxNumber: | 5162486841 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 FRANKLIN AVE | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | GARDEN CITY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115302926 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5162486868 | ||||||||
| FaxNumber: | 5162486841 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/12/2007 | ||||||||
| LastUpdateDate: | 02/03/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 154256 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207RP1001X | 154256 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
ID Information
| ID | Type | State | Issuer | Description | 01484899 | 05 | NY | MEDICAID | A400013240 | 01 | NY | MEDICARE | OTHER |