Provider Demographics
NPI:1245640846
Name:SELTZER, ANDREW PAUL
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:PAUL
Last Name:SELTZER
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 1:201 E 87TH ST APT 16J
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-3215
Mailing Address - Country:US
Mailing Address - Phone:212-348-0175
Mailing Address - Fax:
Practice Address - Street 1:201 EAST 87TH ST. APT. 16J
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3215
Practice Address - Country:US
Practice Address - Phone:212-348-0175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-05
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011877-1103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling