Provider Demographics
NPI:1770550949
Name:PLACENTRA SESSO, EVA FRANCES (DO)
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:FRANCES
Last Name:PLACENTRA SESSO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 E CITY AVE
Mailing Address - Street 2:STE 240
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1708
Mailing Address - Country:US
Mailing Address - Phone:610-660-9895
Mailing Address - Fax:610-660-9755
Practice Address - Street 1:301 E CITY AVE
Practice Address - Street 2:STE 240
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1708
Practice Address - Country:US
Practice Address - Phone:610-660-9895
Practice Address - Fax:610-660-9755
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-07
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0S005160L207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001092132006Medicaid
D98765Medicare UPIN
PA001092132006Medicaid