Doctor Name: | MARY SESAY-ROGERS |
NPI Number: | 1770966038 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-BC |
License Number: | F339578-1 |
Business Practice Address: | 296 N 12th Pl Prospect Park, NJ - 075082217 |
Business Phone Number: | 9735633368 |
Business Fax Number: | |
Mailing Address: | 296 N 12th Pl, PROSPECT PARK |
State: | NJ |
Postal Code: | 075082217 |
Phone Number: | 9735633368 |
Fax Number: | |
NPI Enumeration Date: | 07/06/2015 |
NPI Last Update Date: | 07/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | F339578-1 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |