Healthcare Provider Details

I. General information

NPI: 1154798643
Provider Name (Legal Business Name): MRS. JONATHAN EMMANUEL SESMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2015
Last Update Date: 08/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 ROCKAWAY PKWY
BROOKLYN NY
11236-2339
US

IV. Provider business mailing address

1310 ROCKAWAY PKWY
BROOKLYN NY
11236-2339
US

V. Phone/Fax

Practice location:
  • Phone: 718-272-3300
  • Fax: 718-927-1801
Mailing address:
  • Phone: 718-272-3300
  • Fax: 718-927-1801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: