Provider Demographics
NPI:1972651677
Name:GILEK-SEIBERT, KATARZYNA JOLANTA (MD)
Entity Type:Individual
Prefix:
First Name:KATARZYNA
Middle Name:JOLANTA
Last Name:GILEK-SEIBERT
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 1:50 MAUDE ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908-4325
Mailing Address - Country:US
Mailing Address - Phone:401-456-2699
Mailing Address - Fax:401-456-2684
Practice Address - Street 1:50 MAUDE ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908-4325
Practice Address - Country:US
Practice Address - Phone:401-456-2699
Practice Address - Fax:401-456-2684
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2014-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD14755207RR0500X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA496600OtherTUFTS
MA1302868Medicaid
MAJ42305OtherBLUECROSS
MAAA98667OtherHARVARD PILGRIM
MA000343901Medicare UPIN
MA000343901Medicare PIN
MA343901Medicare PIN