Basic Information
| Provider Information | |||||||||
| NPI: | 1760490502 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SESSA | ||||||||
| FirstName: | EDWARD | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 700 MCCLELLAN ST | ||||||||
| Address2: | |||||||||
| City: | SCHENECTADY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 123041019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5183725637 | ||||||||
| FaxNumber: | 5183721384 | ||||||||
| Practice Location | |||||||||
| Address1: | 700 MCCLELLAN ST | ||||||||
| Address2: | |||||||||
| City: | SCHENECTADY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 123041019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5183725637 | ||||||||
| FaxNumber: | 5183721384 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 127052 | NY | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 00543655 | 05 | NY | MEDICAID | 47355 | 01 | NY | GHI/HMO | OTHER | 000401373001 | 01 | NY | BSNENY | OTHER | 10001861 | 01 | NY | CDPHP | OTHER | 26109 | 01 | NY | MVP | OTHER | 7323579 | 01 | NY | AETNA | OTHER | 070102000061 | 01 | NY | FIDELIS | OTHER | 200141 | 01 | NY | SENIOR WHOLE HEALTH | OTHER | 545131 | 01 | NY | EMPIRE BC | OTHER |