Individual
CHERYL ANN SELG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 W MAIN ST STE 300, RIVERHEAD, NY 11901-2813
(631) 772-3266
(631) 369-5433
Mailing address
214 HOLLAND AVE, MEDFORD, NY 11763-3109
(516) 840-3574
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
711530
NY
Other
Enumeration date
01/29/2024
Last updated
01/29/2024
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