Individual
DR. ALEXANDER Z SELIOUTSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
95 E CHAUTAUQUA ST, MAYVILLE, NY 14757-0168
(716) 753-7107
(716) 753-7980
Mailing address
95 E CHAUTAUQUA ST, PO BOX 168, MAYVILLE, NY 14757-0168
(716) 753-7107
(716) 753-7980
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
209688
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00020544403
UNIVERA
NY
01
—
000525727007
BCBSWNY
NY
01
—
0110754
INDEPENDENT HEALTH
NY
05
—
01958516
—
NY
Enumeration date
03/15/2006
Last updated
02/29/2012
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