Provider Demographics
NPI:1568504322
Name:SELTER, STEVEN G (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:G
Last Name:SELTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:102 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:PORT JEFFERSON
Mailing Address - State:NY
Mailing Address - Zip Code:11777-1813
Mailing Address - Country:US
Mailing Address - Phone:631-473-0611
Mailing Address - Fax:631-642-1617
Practice Address - Street 1:102 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:PORT JEFFERSON
Practice Address - State:NY
Practice Address - Zip Code:11777-1813
Practice Address - Country:US
Practice Address - Phone:631-473-0611
Practice Address - Fax:631-642-1617
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY139173207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0057330OtherGHI
NY112665191OtherPHCS
NY112665191OtherMAGNACARE
NY112665191OtherTHE EMPIRE PLAN (UHC)
NY1308OtherVYTRA HEALTH PLANS
NY5689628OtherFIRST HEALTH-CCN NETWORK
NYCP127OtherOXFORD HEALTH PLANS
NY0569674OtherCIGNA HEALTHCARE
NY112665191OtherGREAT-WEST HEALTHCARE
NYAA50719OtherMDNY HEALTHCARE
NY35A411OtherEMPIRE BLUECHOICE
NY43917375OtherMULTIPLAN
NY000000093117OtherGHI - HMO
NY0H644POtherHIP
NY28063OtherAETNA HMO PROVIDER NUMBER
NY3C8937OtherHEALTH NET
NY4061665OtherAETNA PROVIDER NUMBER
NY28063OtherAETNA HMO PROVIDER NUMBER
NYAA50719OtherMDNY HEALTHCARE