Provider Demographics
NPI:1821195330
Name:SICAT, MARIA A (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:A
Last Name:SICAT
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 1:1650 HUNTINGDON PIKE
Mailing Address - Street 2:SUITE 311
Mailing Address - City:MEADOWBROOK
Mailing Address - State:PA
Mailing Address - Zip Code:19046
Mailing Address - Country:US
Mailing Address - Phone:215-938-1025
Mailing Address - Fax:215-938-1043
Practice Address - Street 1:1650 HUNTINGDON PIKE
Practice Address - Street 2:SUITE 311
Practice Address - City:MEADOWBROOK
Practice Address - State:PA
Practice Address - Zip Code:19046
Practice Address - Country:US
Practice Address - Phone:215-938-1025
Practice Address - Fax:215-938-1043
Is Sole Proprietor?:No
Enumeration Date:2006-09-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-055784-L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G09912Medicare UPIN
PA785620Medicare ID - Type Unspecified