Individual
DR. JAKE SEQUEIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 N ACADEMY AVE, DANVILLE, PA 17822-2901
(570) 214-8790
(570) 271-5427
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
MD474511
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/16/2014
Last updated
07/29/2021
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