Healthcare Provider Details

I. General information

NPI: 1366307571
Provider Name (Legal Business Name): ALEENA SEBASTIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 ACORN DR
PARAMUS NJ
07652-4144
US

IV. Provider business mailing address

425 ACORN DR
PARAMUS NJ
07652-4144
US

V. Phone/Fax

Practice location:
  • Phone: 845-680-8600
  • Fax:
Mailing address:
  • Phone: 845-680-8600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number973911
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: