Healthcare Provider Details

I. General information

NPI: 1407476344
Provider Name (Legal Business Name): JOHN ELMY SEHA DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2020
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 RTE 202/206
BRIDGEWATER NJ
08807-1746
US

IV. Provider business mailing address

308 WILLOW AVE
HOBOKEN NJ
07030-3808
US

V. Phone/Fax

Practice location:
  • Phone: 908-704-8778
  • Fax: 908-704-8172
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number25MD00374100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: