Provider Demographics
NPI:1861644031
Name:SELINGER, CRAIG
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:
Last Name:SELINGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:393 16TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-5607
Mailing Address - Country:US
Mailing Address - Phone:917-282-0579
Mailing Address - Fax:
Practice Address - Street 1:393 16TH ST APT 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-5607
Practice Address - Country:US
Practice Address - Phone:917-282-0579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-19
Last Update Date:2008-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015310235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist