Healthcare Provider Details

I. General information

NPI: 1265497309
Provider Name (Legal Business Name): JUDITH KAY SESSENWEIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 08/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 CORNELIA ST SUITE 202
PLATTSBURGH NY
12901-2779
US

IV. Provider business mailing address

8 BROAD ST
PLATTSBURGH NY
12901-3420
US

V. Phone/Fax

Practice location:
  • Phone: 518-562-7777
  • Fax: 518-562-7707
Mailing address:
  • Phone: 518-563-8880
  • Fax: 518-562-1077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberF360121
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: