Provider Demographics
NPI:1982407649
Name:ALAK-DEBERGH, SELIN (MD)
Entity type:Individual
Prefix:DR
First Name:SELIN
Middle Name:
Last Name:ALAK-DEBERGH
Suffix:
Gender:
Credentials:MD
Other - Prefix:DR
Other - First Name:SELIN
Other - Middle Name:
Other - Last Name:ALAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4623 PROSPECT AVE APT 8
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-5342
Mailing Address - Country:US
Mailing Address - Phone:747-306-8057
Mailing Address - Fax:
Practice Address - Street 1:4802 10TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-2916
Practice Address - Country:US
Practice Address - Phone:718-283-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program