Provider Demographics
NPI:1841728383
Name:HENIG, SAGIE MOSHE (MBBS)
Entity type:Individual
Prefix:
First Name:SAGIE
Middle Name:MOSHE
Last Name:HENIG
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1542 TULANE AVE RM 123
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2865
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2000 TULANE AVENUE
Practice Address - Street 2:CLINIC, 2ND FLOOR, ZONE B
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2250
Practice Address - Country:US
Practice Address - Phone:504-962-6363
Practice Address - Fax:504-702-5745
Is Sole Proprietor?:No
Enumeration Date:2017-05-29
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
LA306305207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program