Provider Demographics
NPI:1396860359
Name:RONDON, SELMA (L AC)
Entity Type:Individual
Prefix:MS
First Name:SELMA
Middle Name:
Last Name:RONDON
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:853 BROADWAY
Mailing Address - Street 2:SUITE 1016
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4703
Mailing Address - Country:US
Mailing Address - Phone:212-979-1931
Mailing Address - Fax:212-979-1931
Practice Address - Street 1:853 BROADWAY
Practice Address - Street 2:SUITE 1016
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4703
Practice Address - Country:US
Practice Address - Phone:212-979-1931
Practice Address - Fax:212-979-1931
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY000302-1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist