Healthcare Provider Details

I. General information

NPI: 1841216033
Provider Name (Legal Business Name): SESLE KATELSEN OLSEN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 05/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 E 70TH ST HSS DEPT. OF ANESTHESIOLOGY
NEW YORK NY
10021-4823
US

IV. Provider business mailing address

GPO BOX 27578
NEW YORK NY
10087-7578
US

V. Phone/Fax

Practice location:
  • Phone: 212-606-1036
  • Fax: 212-517-4481
Mailing address:
  • Phone: 631-329-6925
  • Fax: 631-329-6951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number287564
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number287564
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: