Provider Demographics
NPI:1538170634
Name:SEENEY, SUENY M (MD)
Entity type:Individual
Prefix:
First Name:SUENY
Middle Name:M
Last Name:SEENEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22581
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-2581
Mailing Address - Country:US
Mailing Address - Phone:610-482-4795
Mailing Address - Fax:856-528-3117
Practice Address - Street 1:1098 W BALTIMORE PIKE
Practice Address - Street 2:SUITE#3109
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5139
Practice Address - Country:US
Practice Address - Phone:484-443-2880
Practice Address - Fax:484-443-2885
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD049456L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA196113OtherHIGHMARK BLUE SHIELD ASSIGNMENT ACCOUNT
PA0016205750002Medicaid
PA196113OtherHIGHMARK BLUE SHIELD ASSIGNMENT ACCOUNT
PAF87580Medicare UPIN