Healthcare Provider Details

I. General information

NPI: 1487833810
Provider Name (Legal Business Name): MICHAEL SESSA RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2007
Last Update Date: 11/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 BUTTERNUT ST
SYRACUSE NY
13208-2628
US

IV. Provider business mailing address

4963 MARSH POINTE
LIVERPOOL NY
13090-3616
US

V. Phone/Fax

Practice location:
  • Phone: 315-471-1204
  • Fax: 315-471-0871
Mailing address:
  • Phone: 315-453-1486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number039641
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: