Provider Demographics
NPI:1912005711
Name:SAUGY, JOHN A JR (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:SAUGY
Suffix:JR
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 1:53 BRENTWOOD RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-6948
Mailing Address - Country:US
Mailing Address - Phone:631-665-1566
Mailing Address - Fax:631-665-1513
Practice Address - Street 1:53 BRENTWOOD RD
Practice Address - Street 2:SUITE A
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-6948
Practice Address - Country:US
Practice Address - Phone:631-665-1566
Practice Address - Fax:631-665-1513
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY210416207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
H16063Medicare UPIN
13Q161Medicare ID - Type Unspecified