Provider Demographics
NPI:1073688214
Name:SUSSEX INTERNAL MEDICINE LLC
Entity Type:Organization
Organization Name:SUSSEX INTERNAL MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MANU
Authorized Official - Middle Name:
Authorized Official - Last Name:SEHGAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-422-6778
Mailing Address - Street 1:29 GOSLING DR
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-9588
Mailing Address - Country:US
Mailing Address - Phone:302-422-6778
Mailing Address - Fax:302-422-6779
Practice Address - Street 1:515 S DUPONT BLVD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-1757
Practice Address - Country:US
Practice Address - Phone:302-422-6778
Practice Address - Fax:302-422-6779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2011-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0006888207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1447322060OtherNPI TYPE 1