Provider Demographics
NPI:1346689940
Name:SEPE, PRISCILLA LINNE (MD)
Entity Type:Individual
Prefix:DR
First Name:PRISCILLA
Middle Name:LINNE
Last Name:SEPE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2026 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-1004
Mailing Address - Country:US
Mailing Address - Phone:215-368-4434
Mailing Address - Fax:215-367-7579
Practice Address - Street 1:2026 N BROAD ST
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-1004
Practice Address - Country:US
Practice Address - Phone:215-368-4434
Practice Address - Fax:215-367-7579
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD455694207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA522645Medicare PIN