Healthcare Provider Details

I. General information

NPI: 1326085788
Provider Name (Legal Business Name): MARIE SESNY RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIE E ROLLMAN

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 06/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 WASHINGTON ST
HARRISBURG PA
17104-1675
US

IV. Provider business mailing address

118 WASHINGTON ST
HARRISBURG PA
17104-1677
US

V. Phone/Fax

Practice location:
  • Phone: 717-221-6258
  • Fax: 717-221-6266
Mailing address:
  • Phone: 717-231-8539
  • Fax: 717-231-8588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number381385
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberDN002176
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: