Provider Demographics
NPI:1720081540
Name:TSYGANOV, IGOR V (MD)
Entity Type:Individual
Prefix:
First Name:IGOR
Middle Name:V
Last Name:TSYGANOV
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 1:2401 BAY AVE
Mailing Address - Street 2:
Mailing Address - City:OCEAN CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08226-2456
Mailing Address - Country:US
Mailing Address - Phone:609-399-6102
Mailing Address - Fax:609-399-4424
Practice Address - Street 1:2401 BAY AVE
Practice Address - Street 2:
Practice Address - City:OCEAN CITY
Practice Address - State:NJ
Practice Address - Zip Code:08226-2456
Practice Address - Country:US
Practice Address - Phone:609-399-6300
Practice Address - Fax:609-399-6284
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07421200207L00000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8894302Medicaid
NJ8894302Medicaid
H70887Medicare UPIN