Provider Demographics
NPI:1447393624
Name:SELLA, CARMEN L (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:L
Last Name:SELLA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:CARMEN
Other - Middle Name:
Other - Last Name:SELLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6501 LOISDALE CT
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150-1826
Mailing Address - Country:US
Mailing Address - Phone:703-922-1553
Mailing Address - Fax:
Practice Address - Street 1:6501 LOISDALE CT
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-1826
Practice Address - Country:US
Practice Address - Phone:703-922-1553
Practice Address - Fax:703-922-1641
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202007290183500000X, 183500000X, 1835P1200X
MD136811835P1200X
PR002004183500000X
DCPH100000649183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Yes183500000XPharmacy Service ProvidersPharmacist