MEDICARE: MS. RHONDA SEALEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	72-089911	NY

General Provider Information

NPI Number	:	1881046761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RHONDA SEALEY

Provider Business Mailing Address
First Line	:	590 EAST 3RD STREET
Second Line	:	APT 1E
City	:	MOUNT VERNON
State	:	NY
Zip	:	10553
Country	:	US
Telephone Number	:	917-213-2710
Fax Number	:

Provider Business Practice Location Address
First Line	:	590 E 3RD ST
Second Line	:	APT 1E
City	:	MOUNT VERNON
State	:	NY
Zip	:	10553-1819
Country	:	US
Telephone Number	:	917-213-2710
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2016
Last Update Date	:	07/05/2016

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