Provider Demographics
NPI:1437332004
Name:SELICK, INNA (NP)
Entity Type:Individual
Prefix:
First Name:INNA
Middle Name:
Last Name:SELICK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:INNA
Other - Middle Name:
Other - Last Name:MUSHKATINSKAYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:622 WEST 168TH STREET
Mailing Address - Street 2:PH 5, SUITE 505C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3720
Mailing Address - Country:US
Mailing Address - Phone:212-305-9878
Mailing Address - Fax:212-305-8980
Practice Address - Street 1:622 WEST 168TH STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3720
Practice Address - Country:US
Practice Address - Phone:212-305-9878
Practice Address - Fax:212-305-8980
Is Sole Proprietor?:No
Enumeration Date:2007-12-06
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF430376-1363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care