Provider Demographics
NPI:1811769672
Name:SELMAN, ERICA (MSE, MSED SBL/SDL)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:SELMAN
Suffix:
Gender:F
Credentials:MSE, MSED SBL/SDL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:388 WEST 125TH STREET CENTRAL OFFICE
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:NY
Mailing Address - Zip Code:10027-6204
Mailing Address - Country:US
Mailing Address - Phone:212-342-8401
Mailing Address - Fax:
Practice Address - Street 1:388 WEST 125TH STREET CENTRAL OFFICE
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:NY
Practice Address - Zip Code:10027-6202
Practice Address - Country:US
Practice Address - Phone:212-342-8401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-25
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1186953174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist