Basic Information
| Provider Information | |||||||||
| NPI: | 1346334661 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DODDI | ||||||||
| FirstName: | SESHAGIRI | ||||||||
| MiddleName: | R. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10 OLD JACKSON AVE | ||||||||
| Address2: | UNIT # 37 | ||||||||
| City: | HASTINGS ON HUDSON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 107063203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9149255366 | ||||||||
| FaxNumber: | 9149255169 | ||||||||
| Practice Location | |||||||||
| Address1: | 275 NORTH ST | ||||||||
| Address2: | |||||||||
| City: | HARRISON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105281524 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9149255366 | ||||||||
| FaxNumber: | 9149255169 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2006 | ||||||||
| LastUpdateDate: | 10/10/2007 | ||||||||
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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 | 2084P0805X | 142244 | NY | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Geriatric Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 00823170 | 05 | NY | MEDICAID |