Individual
DR. KELLY SAMANTHA SESSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
6034 76TH ST, MIDDLE VILLAGE, NY 11379-5228
(718) 419-3219
Mailing address
6034 76TH ST, MIDDLE VILLAGE, NY 11379-5228
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
066237
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
066237
NYS LICENSE
NY
Enumeration date
08/28/2020
Last updated
08/28/2020
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