Provider Demographics
NPI:1659393585
Name:FREDERICK W. HEGGAN, D.O. P.A.
Entity Type:Organization
Organization Name:FREDERICK W. HEGGAN, D.O. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:W
Authorized Official - Last Name:HEGGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:609-814-9550
Mailing Address - Street 1:3320 SIMPSON AVE
Mailing Address - Street 2:TRADERS LANE
Mailing Address - City:OCEAN CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08226-2044
Mailing Address - Country:US
Mailing Address - Phone:609-814-9550
Mailing Address - Fax:609-814-9544
Practice Address - Street 1:3320 SIMPSON AVE
Practice Address - Street 2:TRADERS LANE
Practice Address - City:OCEAN CITY
Practice Address - State:NJ
Practice Address - Zip Code:08226-2044
Practice Address - Country:US
Practice Address - Phone:609-814-9550
Practice Address - Fax:609-814-9544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB02587100207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0535261OtherAETNA US HEALTHCARE
NJ379996OtherKEYSTONE HEALTH PLAN EAST
NJ0183776001OtherAMERIHEALTH
NJ7059108OtherAMERIGROUP
NJ16712OtherUNIVERSITY HEALTH PLANS
PA452052OtherPENNSYLVANIA BLUE SHIELD
NJ080138059OtherRAILROAD MEDICARE
NJ1078905OtherHORIZON MERCY HEALTH PLAN
NJP418240OtherOXFORD
NJ7059108Medicaid
NJ=========OtherAETNA US HEALTHCARE
NJ379996OtherKEYSTONE HEALTH PLAN EAST
PA452052OtherPENNSYLVANIA BLUE SHIELD
NJP418240OtherOXFORD
NJ0183776001OtherAMERIHEALTH
PA452052OtherPENNSYLVANIA BLUE SHIELD
NJ7059108Medicaid