Provider Demographics
NPI:1841538295
Name:SIGDEL, BINAYAK
Entity type:Individual
Prefix:
First Name:BINAYAK
Middle Name:
Last Name:SIGDEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3242 SUSON CT, APARTMENT 2
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS
Mailing Address - State:NY
Mailing Address - Zip Code:10451-5504
Mailing Address - Country:US
Mailing Address - Phone:718-579-5030
Mailing Address - Fax:
Practice Address - Street 1:3242 SUSON CT, APARTMENT 2
Practice Address - Street 2:
Practice Address - City:ST LOUIS
Practice Address - State:NY
Practice Address - Zip Code:10451-5504
Practice Address - Country:US
Practice Address - Phone:718-579-5030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-18
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
282N00000X
MO20130274542080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No282N00000XHospitalsGeneral Acute Care Hospital