Provider Demographics
NPI:1568727378
Name:SELEZNEV, ANNA
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:
Last Name:SELEZNEV
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 BAY 26TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-4905
Mailing Address - Country:US
Mailing Address - Phone:646-752-1442
Mailing Address - Fax:
Practice Address - Street 1:133 MORNINGSIDE AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-4802
Practice Address - Country:US
Practice Address - Phone:212-923-2525
Practice Address - Fax:212-222-6397
Is Sole Proprietor?:No
Enumeration Date:2012-07-08
Last Update Date:2012-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY612935163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse