Healthcare Provider Details

I. General information

NPI: 1104036623
Provider Name (Legal Business Name): GABRIEL SELLA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 N 4TH ST STE 12
MARTINS FERRY OH
43935-1600
US

IV. Provider business mailing address

92 N 4TH ST STE 12
MARTINS FERRY OH
43935-1600
US

V. Phone/Fax

Practice location:
  • Phone: 740-633-4485
  • Fax: 740-633-4141
Mailing address:
  • Phone: 740-633-4485
  • Fax: 740-633-4141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number51365
License Number StateOH

VIII. Authorized Official

Name: DR. GABRIEL E. SELLA
Title or Position: OWNER
Credential: M.D.
Phone: 740-633-4485