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Individual

DR. SELENE BANTZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
10 BARCLAY ST, STE 29D, NEW YORK, NY 10007-2714
(917) 765-5960
Mailing address
10 BARCLAY ST, SUITE 29D, NEW YORK, NY 10007-2714
(609) 682-0218
(401) 340-1649

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
1619111366
CT
2080P0201X
Pediatric Allergy/Immunology Physician
1619111366
CT

Other

Enumeration date
04/24/2009
Last updated
07/01/2020
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