Healthcare Provider Details

I. General information

NPI: 1033044177
Provider Name (Legal Business Name): MOHAMED SESAY
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 DAVIDS DR
ASTON PA
19014-1447
US

IV. Provider business mailing address

1007 DAVIDS DR
ASTON PA
19014-1447
US

V. Phone/Fax

Practice location:
  • Phone: 267-251-0979
  • Fax:
Mailing address:
  • Phone: 267-776-3892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN617304
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: