Healthcare Provider Details

I. General information

NPI: 1649389701
Provider Name (Legal Business Name): SEZELLE GEREAU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SEZELLE GEREAU-HADDON

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 10/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SEZELLE GEREAU INC 33 DAFFODIL HILL ROAD
GARRISON NY
10524
US

IV. Provider business mailing address

33 DAFFODIL HILL ROAD
GARRISON NY
10524
US

V. Phone/Fax

Practice location:
  • Phone: 347-680-7085
  • Fax: 646-935-2272
Mailing address:
  • Phone: 347-680-7085
  • Fax: 646-935-2272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number153392
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: