Provider Demographics
NPI:1740761253
Name:SEO, ALICE (NP)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:
Last Name:SEO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 W 51ST ST STE 340
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1951
Mailing Address - Country:US
Mailing Address - Phone:212-326-8830
Mailing Address - Fax:
Practice Address - Street 1:51 W 51ST ST STE 340
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1951
Practice Address - Country:US
Practice Address - Phone:212-326-8830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-22
Last Update Date:2025-09-25
Deactivation Date:2024-06-28
Deactivation Code:
Reactivation Date:2024-07-12
Provider Licenses
StateLicense IDTaxonomies
PANPPA062415363LF0000X
NY352658363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily