Provider Demographics
NPI:1073532255
Name:SEAVY & SESTITO INTERNAL MEDICINE ASSOC
Entity Type:Organization
Organization Name:SEAVY & SESTITO INTERNAL MEDICINE ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEAVY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:215-368-3456
Mailing Address - Street 1:115 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:HATFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19440-2468
Mailing Address - Country:US
Mailing Address - Phone:215-368-3456
Mailing Address - Fax:
Practice Address - Street 1:115 E BROAD ST
Practice Address - Street 2:
Practice Address - City:HATFIELD
Practice Address - State:PA
Practice Address - Zip Code:19440-2468
Practice Address - Country:US
Practice Address - Phone:215-368-3456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS012690207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAI24670Medicare UPIN