Provider Demographics
NPI:1568414746
Name:SELMAN, JAY EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:JAY
Middle Name:EDWARD
Last Name:SELMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 BRADHURST AVE
Mailing Address - Street 2:
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1637
Mailing Address - Country:US
Mailing Address - Phone:914-831-2480
Mailing Address - Fax:815-366-8194
Practice Address - Street 1:95 BRADHURST AVE
Practice Address - Street 2:
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1637
Practice Address - Country:US
Practice Address - Phone:914-831-2480
Practice Address - Fax:815-366-8194
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2016-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1206782084N0402X, 2084N0600X, 2084P0005X, 208000000X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No2084P0005XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurodevelopmental Disabilities
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00325580Medicaid
NY92Z001Medicare ID - Type Unspecified
NY00325580Medicaid