Healthcare Provider Details

I. General information

NPI: 1568391258
Provider Name (Legal Business Name): DEMBA SEY NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

576 56TH ST UNIT 502
WEST NEW YORK NJ
07093-1296
US

IV. Provider business mailing address

576 56TH ST UNIT 502
WEST NEW YORK NJ
07093-1296
US

V. Phone/Fax

Practice location:
  • Phone: 202-299-7497
  • Fax:
Mailing address:
  • Phone: 202-299-7497
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number408598
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: