Provider Demographics
NPI:1174503627
Name:SESE, LINDA Q (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:Q
Last Name:SESE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 MARYLAND RD
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-4008
Mailing Address - Country:US
Mailing Address - Phone:201-967-0148
Mailing Address - Fax:201-967-0148
Practice Address - Street 1:37 8TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-3901
Practice Address - Country:US
Practice Address - Phone:718-636-5900
Practice Address - Fax:718-636-5902
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY112251207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00203003Medicaid
01HCRKMedicare PIN
NY00203003Medicaid
E51742Medicare UPIN