| Sandira V Segaram Md Llc | |
|
653 Willow Grove St Suite 1600 Hackettstown NJ 07840-1732 | |
| (908) 813-2888 | |
| (908) 813-2521 |
| Full Name | Sandira V Segaram Md Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 653 Willow Grove St, Hackettstown, New Jersey |
| Authorized Official Name and Position | Sandira Vaithia Segaram (PHYSICIAN OWNER) |
| Authorized Official Contact | 9088132888 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sandira V Segaram Md Llc 653 Willow Grove St Suite 1600 Hackettstown NJ 07840-1732 Ph: (908) 813-2888 | Sandira V Segaram Md Llc 653 Willow Grove St Suite 1600 Hackettstown NJ 07840-1732 Ph: (908) 813-2888 |
| NPI Number | 1437295227 |
|---|---|
| Provider Enumeration Date | 01/29/2007 |
| Last Update Date | 01/08/2008 |
| Medicare PECOS PAC ID | 5597856260 |
|---|---|
| Medicare Enrollment ID | O20070809000488 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437295227 | NPI | - | NPPES |
| 1928902 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 25MA05040500 (New Jersey) | Primary |
| Provider Name | Sandira V Segaram |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508813346 PECOS PAC ID: 0446341127 Enrollment ID: I20070809000542 |
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