Provider Demographics
NPI:1275566150
Name:SAYEGH, JOHN W (C)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:W
Last Name:SAYEGH
Suffix:
Gender:M
Credentials:C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 S BROADWAY STE LT
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-2015
Mailing Address - Country:US
Mailing Address - Phone:914-968-7821
Mailing Address - Fax:914-968-1237
Practice Address - Street 1:260 S BROADWAY STE LT
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705-2015
Practice Address - Country:US
Practice Address - Phone:914-968-7821
Practice Address - Fax:914-968-1237
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX073470111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01812573Medicaid
NYU43857Medicare UPIN
NYX59641Medicare ID - Type Unspecified