Healthcare Provider Details

I. General information

NPI: 1396322707
Provider Name (Legal Business Name): SAYEDATUN NESSA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1925 PACIFIC AVE
ATLANTIC CITY NJ
08401-6713
US

IV. Provider business mailing address

1925 PACIFIC AVE
ATLANTIC CITY NJ
08401-6713
US

V. Phone/Fax

Practice location:
  • Phone: 609-345-4000
  • Fax:
Mailing address:
  • Phone: 609-345-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number25MA13076600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: