Provider Demographics
NPI:1528783073
Name:SESAY, MARY
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:SESAY
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 1:8480 SNOWDEN OAKS PL
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-2302
Mailing Address - Country:US
Mailing Address - Phone:202-650-8335
Mailing Address - Fax:
Practice Address - Street 1:7474 GREENWAY CENTER DR
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3504
Practice Address - Country:US
Practice Address - Phone:202-650-8335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-06
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR22420363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner