Provider Demographics
NPI:1588807770
Name:SELL, DAVID MAURICE (LMT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:MAURICE
Last Name:SELL
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 OAKLAND ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-2464
Mailing Address - Country:US
Mailing Address - Phone:585-967-0923
Mailing Address - Fax:
Practice Address - Street 1:481 PENBROOKE DR
Practice Address - Street 2:SUITE 5
Practice Address - City:PENFIELD
Practice Address - State:NY
Practice Address - Zip Code:14526-2044
Practice Address - Country:US
Practice Address - Phone:585-967-0923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-17
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017542-1225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist