Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | S102390 | NJ |
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 35SI00239000 | NJ |
NPI | 1013097138 |
---|---|
Provider Name | Richard Selznick |
First Address | Camden, NJ 08103-1088 |
Second Address | Moorestown, NJ 08057 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 03/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2030815 | UNITED HEALTHCARE (01) | NJ |
26129 | UNIVERSITY HEALTH PLAN (01) | NJ |
3K5451 | HEALTHNET, INC (01) | NJ |
41023 | AETNA US HEALTHCARE (01) | NJ |
6859801 | (05) | NJ |
91193 | AMERIGROUP (01) | NJ |
P2704835 | OXFORD (01) | NJ |