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Organization
SELDEN PRIMARY MEDICINE,P.C.
Active
Organization
SELDEN PRIMARY MEDICINE,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICIA ELAINE WEBLEY-BETHUNE M.D. (PRESIDENT)
(631) 736-7220
Entity
Organization
Contact information
Practice address
12 NEW LN, SELDEN, NY 11784-3322
(631) 736-7220
(631) 736-7307
Mailing address
12 NEW LN, SELDEN, NY 11784-3322
(631) 736-7220
(631) 736-7307
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
182907
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01693356
—
NY
01
—
063AD1
EMPIRE BLUE CROSS/SHIELD
NY
01
—
1518962000
INDIVIDUAL NPI NUMBER
NY
Enumeration date
11/02/2007
Last updated
11/02/2007
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