Provider Demographics
NPI:1972597482
Name:SERGI, ANTHONY R (DPM)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:R
Last Name:SERGI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1628 OAK TREE RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-2841
Mailing Address - Country:US
Mailing Address - Phone:732-494-5601
Mailing Address - Fax:732-321-6530
Practice Address - Street 1:1628 OAK TREE RD
Practice Address - Street 2:SUITE 2
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-2841
Practice Address - Country:US
Practice Address - Phone:732-494-5601
Practice Address - Fax:732-321-6530
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD001984213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist