Provider Demographics
NPI:1073687703
Name:SIBBERING AND MIELNICKI, ASSOC.,PC
Entity Type:Organization
Organization Name:SIBBERING AND MIELNICKI, ASSOC.,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MIELNICKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-588-6197
Mailing Address - Street 1:5221 MILFORD RD
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18302
Mailing Address - Country:US
Mailing Address - Phone:570-588-6197
Mailing Address - Fax:570-588-3402
Practice Address - Street 1:5221 MILFORD RD
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18302
Practice Address - Country:US
Practice Address - Phone:570-588-6197
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACD1505Medicare PIN