Healthcare Provider Details

I. General information

NPI: 1982324349
Provider Name (Legal Business Name): MRS. HAJA BINTA KARGBO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HAJA BINTA SESAY NP

II. Dates (important events)

Enumeration Date: 08/29/2022
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MATAWAN RD
MATAWAN NJ
07747-3911
US

IV. Provider business mailing address

100 MATAWAN RD
MATAWAN NJ
07747-3911
US

V. Phone/Fax

Practice location:
  • Phone: 914-454-7919
  • Fax: 914-222-8764
Mailing address:
  • Phone: 914-454-7919
  • Fax: 914-222-8764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF404388-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: