Provider Demographics
NPI:1790415081
Name:SEALY, RENEE
Entity Type:Individual
Prefix:MISS
First Name:RENEE
Middle Name:
Last Name:SEALY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:
Other - Last Name:SEALY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:91 HALSEY ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-1902
Mailing Address - Country:US
Mailing Address - Phone:347-382-4090
Mailing Address - Fax:
Practice Address - Street 1:91 HALSEY ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-1902
Practice Address - Country:US
Practice Address - Phone:631-464-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-10
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)