Healthcare Provider Details

I. General information

NPI: 1174230874
Provider Name (Legal Business Name): ABU SESAY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2022
Last Update Date: 11/01/2022
Certification Date: 11/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

773 OAKLEY DR
DELAWARE OH
43015-1291
US

IV. Provider business mailing address

773 OAKLEY DR
DELAWARE OH
43015-1291
US

V. Phone/Fax

Practice location:
  • Phone: 260-433-0357
  • Fax:
Mailing address:
  • Phone: 260-433-0357
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: