Healthcare Provider Details

I. General information

NPI: 1285231605
Provider Name (Legal Business Name): FATMATA SESAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2020
Last Update Date: 12/16/2020
Certification Date: 12/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6495 NEW HAMPSHIRE AVE
HYATTSVILLE MD
20783-3245
US

IV. Provider business mailing address

14725 4TH ST
LAUREL MD
20707-3978
US

V. Phone/Fax

Practice location:
  • Phone: 240-825-3153
  • Fax:
Mailing address:
  • Phone: 240-677-8767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberA00085570
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: