Healthcare Provider Details

I. General information

NPI: 1518535772
Provider Name (Legal Business Name): SELIM DEMIRDELEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2021
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8831 55TH AVE STE 201
ELMHURST NY
11373-5293
US

IV. Provider business mailing address

55 WATER ST FL 2
NEW YORK NY
10041-0010
US

V. Phone/Fax

Practice location:
  • Phone: 718-899-6600
  • Fax: 718-606-3881
Mailing address:
  • Phone: 646-680-2888
  • Fax: 516-542-5556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number339352
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: