MEDICARE: SIBBERING AND MIELNICKI, ASSOC.,PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1073687703
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIBBERING AND MIELNICKI, ASSOC.,PC

Provider Business Mailing Address
First Line	:	5221 MILFORD RD
Second Line	:
City	:	EAST STROUDSBURG
State	:	PA
Zip	:	18302
Country	:	US
Telephone Number	:	570-588-6197
Fax Number	:	570-588-3402

Provider Business Practice Location Address
First Line	:	5221 MILFORD RD
Second Line	:
City	:	EAST STROUDSBURG
State	:	PA
Zip	:	18302
Country	:	US
Telephone Number	:	570-588-6197
Fax Number	:

Authorized Official
Title or Position	:	TREASURER
Name	:	DR. STANLEY MIELNICKI
Credential	:	MD
Telephone Number	:	570-588-6197

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	06/29/2010

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