| Sps Medical Pc | |
|
4250 Hempstead Tpke Suiite 19 Bethpage NY 11714 | |
| (516) 735-5522 | |
| (516) 644-5385 |
| Full Name | Sps Medical Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4250 Hempstead Tpke, Bethpage, New York |
| Authorized Official Name and Position | Prem L Sagar (OWNER) |
| Authorized Official Contact | 5167355522 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sps Medical Pc 141 Melanie Dr East Meadow NY 11554-1436 Ph: (516) 735-5522 | Sps Medical Pc 4250 Hempstead Tpke Suiite 19 Bethpage NY 11714 Ph: (516) 735-5522 |
| NPI Number | 1871634253 |
|---|---|
| Provider Enumeration Date | 02/09/2007 |
| Last Update Date | 06/23/2008 |
| Medicare PECOS PAC ID | 4688650708 |
|---|---|
| Medicare Enrollment ID | O20040628001467 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871634253 | NPI | - | NPPES |
| 01919259 | Medicaid | NY | |
| DC2627 | Other | NY | RAILROAD MEDICARE GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 210715 (New York) | Primary |
| 207RN0300X | Internal Medicine - Nephrology | 202133 (New York) | Secondary |
| Provider Name | Sushil Sagar |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1285699041 PECOS PAC ID: 6305831603 Enrollment ID: I20040416000719 |
| Provider Name | Prem L Sagar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144285479 PECOS PAC ID: 0446237093 Enrollment ID: I20040701001253 |
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