Provider Demographics
NPI:1346488509
Name:SESE, RAYMUND
Entity Type:Individual
Prefix:
First Name:RAYMUND
Middle Name:
Last Name:SESE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:RAYMUND
Other - Middle Name:
Other - Last Name:SESE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:379 GERRY RD
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-3210
Mailing Address - Country:US
Mailing Address - Phone:732-951-8973
Mailing Address - Fax:
Practice Address - Street 1:450 LENOX RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2020
Practice Address - Country:US
Practice Address - Phone:718-270-4217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-27
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004916363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical