Provider Demographics
NPI:1295377844
Name:ADABOO, SELINA
Entity Type:Individual
Prefix:
First Name:SELINA
Middle Name:
Last Name:ADABOO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2523 OCEANCREST BLVD
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-1913
Mailing Address - Country:US
Mailing Address - Phone:347-972-1163
Mailing Address - Fax:
Practice Address - Street 1:2523 OCEANCREST BLVD
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-1913
Practice Address - Country:US
Practice Address - Phone:347-972-1163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-15
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY780152163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse