1568504322 NPI number — DR. STEVEN G. SELTER M.D.

Table of content: SARAH H GOLDEN PH.D. (NPI 1386239184)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568504322 NPI number — DR. STEVEN G. SELTER M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SELTER
Provider First Name:
STEVEN
Provider Middle Name:
G.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568504322
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
102 PROSPECT ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PORT JEFFERSON
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11777-1813
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-473-0611
Provider Business Mailing Address Fax Number:
631-642-1617

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
102 PROSPECT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORT JEFFERSON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11777-1813
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-473-0611
Provider Business Practice Location Address Fax Number:
631-642-1617
Provider Enumeration Date:
02/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  139173 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0057330 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 112665191 . This is a "PHCS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 112665191 . This is a "MAGNACARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 112665191 . This is a "THE EMPIRE PLAN (UHC)" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1308 . This is a "VYTRA HEALTH PLANS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 5689628 . This is a "FIRST HEALTH-CCN NETWORK" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: CP127 . This is a "OXFORD HEALTH PLANS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0569674 . This is a "CIGNA HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 112665191 . This is a "GREAT-WEST HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: AA50719 . This is a "MDNY HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 35A411 . This is a "EMPIRE BLUECHOICE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 43917375 . This is a "MULTIPLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000093117 . This is a "GHI - HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0H644P . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 28063 . This is a "AETNA HMO PROVIDER NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 3C8937 . This is a "HEALTH NET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 4061665 . This is a "AETNA PROVIDER NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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