MEDICARE: STEPHANIE SESSA RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	039470	NY

General Provider Information

NPI Number	:	1417289323
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE SESSA RPH

Provider Business Mailing Address
First Line	:	9679 BREWERTON RD
Second Line	:
City	:	BREWERTON
State	:	NY
Zip	:	13029-8738
Country	:	US
Telephone Number	:	315-676-4441
Fax Number	:	315-676-5255

Provider Business Practice Location Address
First Line	:	9679 BREWERTON RD
Second Line	:
City	:	BREWERTON
State	:	NY
Zip	:	13029-8738
Country	:	US
Telephone Number	:	315-676-4441
Fax Number	:	315-676-5255

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2010
Last Update Date	:	02/02/2010

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