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General NPI Number Information
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NPI Number | 1134429905
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Entity Type | Organization
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Legal Business Name | SEOS MEDICAL PROFESSIONAL ASSOCIATION
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Dates
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Enumeration Date | 10/27/2010
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Last Update Date | 10/27/2010
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Provider Practice Location Address
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Address Line | 184 NATHAN DR
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City | MORGANVILLE
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State | NJ
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Zip | 07751-2205
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Country | US
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Telephone | 718-913-4433
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Fax |
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Provider Business Mailing Address
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Address Line | 184 NATHAN DR
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City | MORGANVILLE
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State | NJ
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Zip | 07751-2205
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Country | US
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Telephone | 718-913-4433
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SANNA KALIKA
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Credential | M.D.
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Telephone | 718-913-4433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 25MA07968600
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License Number State | NJ
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