Provider Demographics
NPI:1659301836
Name:TSIGONIS, NATALIE (DO)
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:
Last Name:TSIGONIS
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 1:119 E LAUREL RD
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08084-1324
Mailing Address - Country:US
Mailing Address - Phone:856-346-3469
Mailing Address - Fax:856-346-9456
Practice Address - Street 1:119 E LAUREL RD
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:NJ
Practice Address - Zip Code:08084-1324
Practice Address - Country:US
Practice Address - Phone:856-346-3469
Practice Address - Fax:856-346-9456
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB06189200207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
2367742000OtherAMERIHEALTH
NJ8548404Medicaid
001693471OtherINDEPENDENCE BLUE CROSS
NJ8548404Medicaid
2367742000OtherAMERIHEALTH