Provider Demographics
NPI:1023438751
Name:SSEGUJJA, WILLIAM
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:SSEGUJJA
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 1:5 BARTON ST
Mailing Address - Street 2:APT 1
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-6008
Mailing Address - Country:US
Mailing Address - Phone:617-412-5972
Mailing Address - Fax:
Practice Address - Street 1:5 BARTONT ST
Practice Address - Street 2:APT 1
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02453-6008
Practice Address - Country:US
Practice Address - Phone:617-412-5972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-21
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2257948163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse