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Individual

PRAFULLA RAJANI SEQUEIRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1503 LANSDOWNE AVE STE 3001, DARBY, PA 19023-1306
(610) 586-4100
(610) 586-4114
Mailing address
264 W ESSEX AVE, LANSDOWNE, PA 19050-1509

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP015777
PA
364SF0001X
Family Health Clinical Nurse Specialist
SP015777
PA
364SG0600X
Gerontology Clinical Nurse Specialist
SP020230
PA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
09/03/2015
Last updated
05/20/2021
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