Provider Demographics
NPI:1790050482
Name:SELLEN, RACHEL (MS, RD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:SELLEN
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 PINE ST STE 4
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07866-3143
Mailing Address - Country:US
Mailing Address - Phone:862-309-9859
Mailing Address - Fax:
Practice Address - Street 1:25 PINE ST STE 4
Practice Address - Street 2:
Practice Address - City:ROCKAWAY
Practice Address - State:NJ
Practice Address - Zip Code:07866-3143
Practice Address - Country:US
Practice Address - Phone:862-309-9859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-14
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN004749133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered