Healthcare Provider Details

I. General information

NPI: 1033020391
Provider Name (Legal Business Name): BABA CEESAY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 NICHOLS ST
ANCHORAGE AK
99508-3458
US

IV. Provider business mailing address

4511 LAUREL ST UNIT 28
ANCHORAGE AK
99507-5202
US

V. Phone/Fax

Practice location:
  • Phone: 907-334-8634
  • Fax: 907-222-6804
Mailing address:
  • Phone: 907-334-8634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: