Healthcare Provider Details

I. General information

NPI: 1760490502
Provider Name (Legal Business Name): EDWARD M SESSA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 MCCLELLAN ST
SCHENECTADY NY
12304-1019
US

IV. Provider business mailing address

700 MCCLELLAN ST
SCHENECTADY NY
12304-1019
US

V. Phone/Fax

Practice location:
  • Phone: 518-372-5637
  • Fax: 518-372-1384
Mailing address:
  • Phone: 518-372-5637
  • Fax: 518-372-1384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number127052
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: