Provider Demographics
NPI:1831135110
Name:SEARES, PETRONILO LIZARDO JR (MD)
Entity Type:Individual
Prefix:DR
First Name:PETRONILO
Middle Name:LIZARDO
Last Name:SEARES
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:35 BEAVERSON BLVD
Mailing Address - Street 2:SUITE 7B
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-7812
Mailing Address - Country:US
Mailing Address - Phone:732-262-2400
Mailing Address - Fax:732-262-3883
Practice Address - Street 1:35 BEAVERSON BLVD
Practice Address - Street 2:SUITE 7B
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-7812
Practice Address - Country:US
Practice Address - Phone:732-262-2400
Practice Address - Fax:732-262-3883
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA053878207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF28429Medicare UPIN