Provider Demographics
NPI:1710922539
Name:SELZER, GERARD BRUNO (MD)
Entity Type:Individual
Prefix:
First Name:GERARD
Middle Name:BRUNO
Last Name:SELZER
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 1:333 BLOOMFIELD AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06117-1544
Mailing Address - Country:US
Mailing Address - Phone:860-523-1736
Mailing Address - Fax:860-523-1758
Practice Address - Street 1:333 BLOOMFIELD AVE
Practice Address - Street 2:SUITE A
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06117-1544
Practice Address - Country:US
Practice Address - Phone:860-523-1736
Practice Address - Fax:860-523-1758
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0177602084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010017760CT01OtherBCBS
CT010017760CT01OtherBCBS