| Provider / Organization | NPI | Date Certified |
|---|---|---|
| STEVAN SELLE | 1366159295 | 2023-01-21 |
Stevan Selle is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1366159295. Registration indicates Stevan Selle is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant, ) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (All Other Specialties & Provider Types, ) (Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers)
| Entity Type | Individual |
| Provider Name | Stevan Selle PA |
| Practice Office Address | 225 WILLIAMSON ST ELIZABETH, NJ US |
| Practice Office Telephone | 9089945000 |
| Mailing Address | 225 WILLIAMSON ST ELIZABETH, NJ 072023625 US |
| Business Telephone | 9089945000 |
| Code | Practice | License No State |
|---|---|---|
| 363A00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician AssistantAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Physician Assistant All Other Specialties & Provider Types Physician Assistant Physician Assistants & Advanced Practice Nursing Providers | 25MP00749800
NJ |