Provider Demographics
NPI:1689810491
Name:SAGIV, OFER (MD)
Entity Type:Individual
Prefix:
First Name:OFER
Middle Name:
Last Name:SAGIV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 HOPMEADOW ST
Mailing Address - Street 2:
Mailing Address - City:SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06070-2496
Mailing Address - Country:US
Mailing Address - Phone:860-272-4646
Mailing Address - Fax:860-272-4642
Practice Address - Street 1:540 HOPMEADOW ST
Practice Address - Street 2:CARDIOLOGY
Practice Address - City:SIMSBURY
Practice Address - State:CT
Practice Address - Zip Code:06070-2496
Practice Address - Country:US
Practice Address - Phone:860-272-4646
Practice Address - Fax:860-272-4642
Is Sole Proprietor?:No
Enumeration Date:2008-12-29
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT047333207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT2247030OtherCOVENTRY
CT9282654OtherAETNA
CT1172386OtherUSA
CT47333OtherCONNECTICARE
CTPENDINGOtherRR MEDICARE
CT9342966OtherCIGNA
CT9282654OtherAETNA