Provider Demographics
NPI:1649811365
Name:SELA, RAMAZAN
Entity type:Individual
Prefix:
First Name:RAMAZAN
Middle Name:
Last Name:SELA
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 1:14 RICHARD SCOTT CT
Mailing Address - Street 2:
Mailing Address - City:NORTH HALEDON
Mailing Address - State:NJ
Mailing Address - Zip Code:07508-1707
Mailing Address - Country:US
Mailing Address - Phone:201-953-4008
Mailing Address - Fax:
Practice Address - Street 1:712 E BAY AVE
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-3447
Practice Address - Country:US
Practice Address - Phone:609-978-0242
Practice Address - Fax:609-978-7177
Is Sole Proprietor?:No
Enumeration Date:2019-10-03
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00550300363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant