Healthcare Provider Details

I. General information

NPI: 1124304035
Provider Name (Legal Business Name): NINA R SESSLER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2011
Last Update Date: 10/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 SENIOR ST
NEW BRUNSWICK NJ
08901-8534
US

IV. Provider business mailing address

117 BROAD ST
FREEHOLD NJ
07728-1942
US

V. Phone/Fax

Practice location:
  • Phone: 646-696-6009
  • Fax:
Mailing address:
  • Phone: 646-696-6009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberTP# 113-051
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: