Provider Demographics
NPI:1003178252
Name:SELIG, ANNETTE (MS ED)
Entity Type:Individual
Prefix:MRS
First Name:ANNETTE
Middle Name:
Last Name:SELIG
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 DAMASCUS DR
Mailing Address - Street 2:
Mailing Address - City:GANSEVOORT
Mailing Address - State:NY
Mailing Address - Zip Code:12831-1454
Mailing Address - Country:US
Mailing Address - Phone:518-421-1060
Mailing Address - Fax:
Practice Address - Street 1:71 DAMASCUS DR
Practice Address - Street 2:
Practice Address - City:GANSEVOORT
Practice Address - State:NY
Practice Address - Zip Code:12831-1454
Practice Address - Country:US
Practice Address - Phone:518-421-1060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist