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General NPI Number Information
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NPI Number | 1588758809
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Entity Type | Individual
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Provider Name | MUHAMMAD TAHIR SELEVANY MD
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Gender | Male
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 10/10/2019
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Provider Practice Location Address
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Address Line | 1003 MAIN AVE
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City | CLIFTON
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State | NJ
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Zip | 07011-2333
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Country | US
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Telephone | 973-777-9595
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Fax | 973-777-1311
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Provider Business Mailing Address
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Address Line | 397 HALEDON AVE STE 104
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City | HALEDON
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State | NJ
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Zip | 07508-1551
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Country | US
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Telephone | 973-777-9595
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Fax | 973-777-1311
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MA06471000
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License Number State | NJ
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