Provider Demographics
NPI:1982681474
Name:SECHERESIU, EMILIA (MD)
Entity Type:Individual
Prefix:
First Name:EMILIA
Middle Name:
Last Name:SECHERESIU
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 1:415 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:FREELAND
Mailing Address - State:PA
Mailing Address - Zip Code:18224
Mailing Address - Country:US
Mailing Address - Phone:570-636-5431
Mailing Address - Fax:570-636-5431
Practice Address - Street 1:500 FIRST ST
Practice Address - Street 2:
Practice Address - City:WEATHERLY
Practice Address - State:PA
Practice Address - Zip Code:18255
Practice Address - Country:US
Practice Address - Phone:570-427-8643
Practice Address - Fax:570-427-8044
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2017-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35061595S207R00000X
PAMD048840L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA002253OtherFIRST PRIORITY HEALTH
PA0000736656OtherBLUE SHIELD
PA0014086130005Medicaid
PA0000736656OtherBLUE SHIELD
E97133Medicare UPIN