Provider Demographics
NPI:1780133488
Name:ALBERT, SELINA
Entity type:Individual
Prefix:
First Name:SELINA
Middle Name:
Last Name:ALBERT
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 1:129 STERLING AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305-1405
Mailing Address - Country:US
Mailing Address - Phone:201-956-8838
Mailing Address - Fax:201-880-5716
Practice Address - Street 1:10 ORCHARD ST
Practice Address - Street 2:3J
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-4830
Practice Address - Country:US
Practice Address - Phone:201-880-5716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-23
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist