Healthcare Provider Details

I. General information

NPI: 1982107942
Provider Name (Legal Business Name): MACERAY SESAY PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2018
Last Update Date: 03/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 MORTON AVE
FOLSOM PA
19033-2521
US

IV. Provider business mailing address

5001 PINE ST APT 1F
PHILADELPHIA PA
19143-1681
US

V. Phone/Fax

Practice location:
  • Phone: 610-237-3810
  • Fax:
Mailing address:
  • Phone: 609-330-1489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP451808
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: