Provider Demographics
NPI:1447225545
Name:SESSA, MARY (APN)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:
Last Name:SESSA
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 FICHTER ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07403-1301
Mailing Address - Country:US
Mailing Address - Phone:973-492-2744
Mailing Address - Fax:
Practice Address - Street 1:151 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-3026
Practice Address - Country:US
Practice Address - Phone:973-622-3900
Practice Address - Fax:973-622-1698
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN05290100363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology