Basic Information
| Provider Information | |||||||||
| NPI: | 1457315376 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SELTER | ||||||||
| FirstName: | JARED | ||||||||
| MiddleName: | G | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2660 MAIN ST STE 216 | ||||||||
| Address2: | |||||||||
| City: | BRIDGEPORT | ||||||||
| State: | CT | ||||||||
| PostalCode: | 066065301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4752103545 | ||||||||
| FaxNumber: | 2035816509 | ||||||||
| Practice Location | |||||||||
| Address1: | 115 TECHNOLOGY DR UNIT C300 | ||||||||
| Address2: | |||||||||
| City: | TRUMBULL | ||||||||
| State: | CT | ||||||||
| PostalCode: | 066116347 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2034457093 | ||||||||
| FaxNumber: | 2036387981 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2006 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 039877 | CT | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.