Provider Demographics
NPI:1578014833
Name:SEJOUR, DUCKENS
Entity Type:Individual
Prefix:
First Name:DUCKENS
Middle Name:
Last Name:SEJOUR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 MOSS PL
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-3613
Mailing Address - Country:US
Mailing Address - Phone:908-220-3891
Mailing Address - Fax:732-898-9461
Practice Address - Street 1:118 MOSS PL
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-0775
Practice Address - Country:US
Practice Address - Phone:908-220-3891
Practice Address - Fax:732-898-9461
Is Sole Proprietor?:No
Enumeration Date:2016-10-20
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0245800374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide