Provider Demographics
NPI:1942363445
Name:SEKULA, RAYMOND FRANCIS (MD)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:FRANCIS
Last Name:SEKULA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 E 2ND ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16507-1532
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:710 W 168TH ST FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3726
Practice Address - Country:US
Practice Address - Phone:212-304-7190
Practice Address - Fax:212-305-2026
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY314103207T00000X
PAMD422007207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1018145620001Medicaid
OH2719419Medicaid
WV3810009799Medicaid
PA1018145620001Medicaid
PA108144N79Medicare PIN