Sisselman, Jill
Sisselman, Jill is an individual health care provider with primary practice located at 627 Broadway Suite 1, Massapequa NY 11758-5031. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Sisselman, Jill can be contacted via phone (516) 308-4040.Contact Information
Primary practice address
627 Broadway Suite 1
Massapequa NY 11758-5031
Phone: (516) 308-4040
Fax: (516) 804-6386
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 216154 | New York |
Profile Details
| NPI number | 1295895480 |
|---|---|
| LBN Legal business name | Sisselman, Jill |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 11th, 2006 |
| Last updated | Oct 12th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295895480 | NPPES |
| New York | MEDICAID | 02236368 |
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