Provider Demographics
NPI:1578802385
Name:LOUIS V SANGOSSE, MD PA
Entity Type:Organization
Organization Name:LOUIS V SANGOSSE, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:V
Authorized Official - Last Name:SANGOSSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-731-0200
Mailing Address - Street 1:745 NORTHFIELD AVE
Mailing Address - Street 2:SUITE #7
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-1144
Mailing Address - Country:US
Mailing Address - Phone:973-731-0200
Mailing Address - Fax:973-325-2244
Practice Address - Street 1:745 NORTHFIELD AVE
Practice Address - Street 2:SUITE #7
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-1144
Practice Address - Country:US
Practice Address - Phone:973-731-0200
Practice Address - Fax:973-325-2244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-14
Last Update Date:2013-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty