Healthcare Provider Details

I. General information

NPI: 1366077141
Provider Name (Legal Business Name): CAITLIN ANNE SESSA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2020
Last Update Date: 03/11/2020
Certification Date: 03/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HEALTHY WAY
OCEANSIDE NY
11572-1551
US

IV. Provider business mailing address

46 ANDOVER RD
ROCKVILLE CENTRE NY
11570-1519
US

V. Phone/Fax

Practice location:
  • Phone: 877-768-8462
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF308254-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: