Provider Demographics
NPI:1124582200
Name:SELIM, TASNIM ABDELNASSER (DC)
Entity Type:Individual
Prefix:DR
First Name:TASNIM
Middle Name:ABDELNASSER
Last Name:SELIM
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2406 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-5421
Mailing Address - Country:US
Mailing Address - Phone:908-731-2651
Mailing Address - Fax:
Practice Address - Street 1:2406 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-5421
Practice Address - Country:US
Practice Address - Phone:908-731-2651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00758600111N00000X
NJ171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty