Provider Demographics
NPI:1255739876
Name:ESASKY, RANDI LEE
Entity type:Individual
Prefix:
First Name:RANDI
Middle Name:LEE
Last Name:ESASKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 TENSAW DR
Mailing Address - Street 2:
Mailing Address - City:BROWNS MILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:08015-6638
Mailing Address - Country:US
Mailing Address - Phone:609-893-0378
Mailing Address - Fax:
Practice Address - Street 1:109 TENSAW DR
Practice Address - Street 2:
Practice Address - City:BROWNS MILLS
Practice Address - State:NJ
Practice Address - Zip Code:08015-6638
Practice Address - Country:US
Practice Address - Phone:609-893-0378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-13
Last Update Date:2014-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health