Provider Demographics
NPI:1508049362
Name:MILFORD INTERNAL MEDICINE ASSOCIATES PC
Entity Type:Organization
Organization Name:MILFORD INTERNAL MEDICINE ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:SEQUEIRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-296-2055
Mailing Address - Street 1:111 E CATHERINE ST STE 220
Mailing Address - Street 2:PO BOX 1614
Mailing Address - City:MILFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18337-1348
Mailing Address - Country:US
Mailing Address - Phone:570-296-2055
Mailing Address - Fax:570-409-0044
Practice Address - Street 1:111 E CATHERINE ST STE 220
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:PA
Practice Address - Zip Code:18337-1348
Practice Address - Country:US
Practice Address - Phone:570-296-2055
Practice Address - Fax:570-409-0044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-14
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD068789L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty