Provider Demographics
NPI:1992482483
Name:SESAY, SHAID
Entity type:Individual
Prefix:
First Name:SHAID
Middle Name:
Last Name:SESAY
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 1:9767 GOOD LUCK RD
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3332
Mailing Address - Country:US
Mailing Address - Phone:240-755-6186
Mailing Address - Fax:410-986-2010
Practice Address - Street 1:9767 GOOD LUCK RD
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3332
Practice Address - Country:US
Practice Address - Phone:240-755-6186
Practice Address - Fax:410-986-2010
Is Sole Proprietor?:No
Enumeration Date:2023-06-28
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA200002903374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide