Healthcare Provider Details

I. General information

NPI: 1164778312
Provider Name (Legal Business Name): FATHIA SESSING M.S. SP. ED., E.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2012
Last Update Date: 07/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 TWIN PINES DR 16C
BROOKLYN NY
11239-1810
US

IV. Provider business mailing address

45 TWIN PINES DR 16C
BROOKLYN NY
11239-1810
US

V. Phone/Fax

Practice location:
  • Phone: 718-942-0905
  • Fax:
Mailing address:
  • Phone: 718-942-0905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number1717111
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: