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Organization

CONVENIENT PRIMARY CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ELENA SELINA (MEDICAL DOCTOR)
(609) 404-0121
Entity
Organization

Contact information

Practice address
48 S NEW YORK RD SUITE B-3, SMITHVILLE, NJ 08205
(609) 404-0121
Mailing address
48 S NEW YORK RD SUITE B-3, SMITHVILLE, NJ 08205
(609) 404-0121

Taxonomy

Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
25MA08815700
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
273265712
TAX ID
NJ
Enumeration date
05/28/2015
Last updated
05/28/2015
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