Provider Demographics
NPI:1114915543
Name:SEHGAL, GEETA (DO)
Entity Type:Individual
Prefix:DR
First Name:GEETA
Middle Name:
Last Name:SEHGAL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860-1010
Mailing Address - Country:US
Mailing Address - Phone:973-383-4500
Mailing Address - Fax:973-383-8943
Practice Address - Street 1:179 HIGH ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-1010
Practice Address - Country:US
Practice Address - Phone:973-383-4500
Practice Address - Fax:973-383-8943
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-10
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB07418100174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8998108Medicaid
NJ064229W3WMedicare PIN
NJH73406Medicare UPIN