Provider Demographics
NPI:1861678278
Name:KRAJA, SELATIN (MD)
Entity Type:Individual
Prefix:
First Name:SELATIN
Middle Name:
Last Name:KRAJA
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 1:7 REMSEN ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-4117
Mailing Address - Country:US
Mailing Address - Phone:718-887-8566
Mailing Address - Fax:718-799-5891
Practice Address - Street 1:7 REMSEN ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-4117
Practice Address - Country:US
Practice Address - Phone:718-887-8566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-15
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY246810207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine