Healthcare Provider Details

I. General information

NPI: 1780575787
Provider Name (Legal Business Name): IVONNE SEXTON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2025
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4462 PARK AVE
BRONX NY
10457-2438
US

IV. Provider business mailing address

4462 BRONX BLVD # 10457
BRONX NY
10470-1408
US

V. Phone/Fax

Practice location:
  • Phone: 844-663-2255
  • Fax:
Mailing address:
  • Phone: 844-663-2255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number685330
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: