Healthcare Provider Details

I. General information

NPI: 1407974413
Provider Name (Legal Business Name): JANE J SELEY GNP CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 EAST 68 STREET NEWYORK PRESBYTERIAN WC ROOM F2025, BOX 136 ENDOCRINE
NEW YORK NY
10021
US

IV. Provider business mailing address

525 EAST 68 STREET ROOM F2025, BOX 136 ENDOCRINE
NEW YORK NY
10021
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-6220
  • Fax: 212-746-8527
Mailing address:
  • Phone: 212-746-6220
  • Fax: 212-746-8527

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number293887
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberF340401
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: