Provider Demographics
NPI:1740974955
Name:SEISAY, FATMATA BINTA
Entity type:Individual
Prefix:
First Name:FATMATA
Middle Name:BINTA
Last Name:SEISAY
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 1:7081 BRADBURY DR
Mailing Address - Street 2:
Mailing Address - City:SUNBURY
Mailing Address - State:OH
Mailing Address - Zip Code:43074-7666
Mailing Address - Country:US
Mailing Address - Phone:240-714-7572
Mailing Address - Fax:
Practice Address - Street 1:7081 BRADBURY DR
Practice Address - Street 2:
Practice Address - City:SUNBURY
Practice Address - State:OH
Practice Address - Zip Code:43074-7666
Practice Address - Country:US
Practice Address - Phone:240-714-7572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UK024880253Z00000X
374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No253Z00000XAgenciesIn Home Supportive Care