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Individual

MS. ILIRIANA SELA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(718) 226-9158
Mailing address
1 EDGEWATER STREET, SUITE 723, STATEN ISLAND, NY 10305
(718) 226-4324
(718) 226-1039

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
010912
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02769597
NY
Enumeration date
07/06/2006
Last updated
02/17/2011
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