Healthcare Provider Details

I. General information

NPI: 1144385790
Provider Name (Legal Business Name): SEAN MICHAEL BARANIAK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 08/16/2023
Certification Date: 08/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

U.S. NAVAL HOSPITAL VIA CONTRADA BOSCARIELLO
GRICIGNANO DI AVERSA CE
81030
IT

IV. Provider business mailing address

PSC 808 BOX 19
FPO AE
09618-0001
US

V. Phone/Fax

Practice location:
  • Phone: 81-811-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number0101242883
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: