Provider Demographics
NPI:1538208368
Name:SELTZER, NADINE D (APRN)
Entity type:Individual
Prefix:MS
First Name:NADINE
Middle Name:D
Last Name:SELTZER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 MIDDLE RIDGE
Mailing Address - Street 2:
Mailing Address - City:NEW CANAAN
Mailing Address - State:CT
Mailing Address - Zip Code:06840
Mailing Address - Country:US
Mailing Address - Phone:203-966-1188
Mailing Address - Fax:203-326-2990
Practice Address - Street 1:587 ELM STREET
Practice Address - Street 2:ST JOSEPH FAMILY LIFE CENTER
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902
Practice Address - Country:US
Practice Address - Phone:203-326-2986
Practice Address - Fax:203-326-2990
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT001089363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Not Answered363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTMS0147632OtherDEA