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General NPI Number Information
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NPI Number | 1629248786
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Entity Type | Organization
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Legal Business Name | STEVEN G SELTER MD
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Dates
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Enumeration Date | 03/05/2008
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Last Update Date | 03/05/2008
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Provider Practice Location Address
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Address Line | 102 PROSPECT ST
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City | PORT JEFFERSON
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State | NY
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Zip | 11777-1813
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Country | US
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Telephone | 631-473-0611
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Fax | 631-642-1617
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Provider Business Mailing Address
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Address Line | 102 PROSPECT ST
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City | PORT JEFFERSON
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State | NY
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Zip | 11777-1813
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Country | US
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Telephone | 631-473-0611
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Fax | 631-642-1617
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Authorized Official
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Title or Position | BILLING COORDINATOR
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Name | MS. CHRISTINE HEGEMEISTER
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Credential |
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Telephone | 516-868-9777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 139173
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License Number State | NY
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