Healthcare Provider Details
I. General information
NPI: 1174503627
Provider Name (Legal Business Name): LINDA Q SESE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/19/2006
Last Update Date: 05/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
37 8TH AVE
BROOKLYN NY
11217-3901
US
IV. Provider business mailing address
76 MARYLAND RD
PARAMUS NJ
07652-4008
US
V. Phone/Fax
- Phone: 718-636-5900
- Fax: 718-636-5902
- Phone: 201-967-0148
- Fax: 201-967-0148
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | 112251 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: