Provider Demographics
NPI:1700648862
Name:WEDLAW, SELA PATRICE
Entity Type:Individual
Prefix:
First Name:SELA
Middle Name:PATRICE
Last Name:WEDLAW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 CENTRE AVE UNIT 401
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-7280
Mailing Address - Country:US
Mailing Address - Phone:914-200-8299
Mailing Address - Fax:
Practice Address - Street 1:111 CENTRE AVE UNIT 401
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-7280
Practice Address - Country:US
Practice Address - Phone:914-200-8299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula