Healthcare Provider Details

I. General information

NPI: 1780790584
Provider Name (Legal Business Name): RICHARD JOHN SEKERAK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 02/20/2020
Certification Date: 02/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 CHERRY ST
MILFORD CT
06460-3501
US

IV. Provider business mailing address

1290 SILAS DEANE HWY FL 1
WETHERSFIELD CT
06109-4337
US

V. Phone/Fax

Practice location:
  • Phone: 203-874-2543
  • Fax: 203-874-2544
Mailing address:
  • Phone: 860-972-6970
  • Fax: 860-972-7040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number030394
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: