Provider Demographics
NPI:1275817439
Name:EVAN D. SEHGAL, MD PA
Entity Type:Organization
Organization Name:EVAN D. SEHGAL, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:SEHGAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-288-4252
Mailing Address - Street 1:777 TERRACE AVENUE
Mailing Address - Street 2:SUITE 311
Mailing Address - City:HASBROUCK HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07604
Mailing Address - Country:US
Mailing Address - Phone:201-288-4252
Mailing Address - Fax:201-288-7172
Practice Address - Street 1:777 TERRACE AVENUE
Practice Address - Street 2:SUITE 311
Practice Address - City:HASBROUCK HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07604
Practice Address - Country:US
Practice Address - Phone:201-288-4252
Practice Address - Fax:201-288-7172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA051350207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ524619AZ5Medicare PIN