MEDICARE: DR. EVAN D SEHGAL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0011X	Interventional Cardiology Physician	25MA05135000	NJ
2	207RC0000X	Cardiovascular Disease Physician	25MA05135000	NJ
3	207R00000X	Internal Medicine Physician	25MA05135000	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	222970871	OTHER	NJ	TAX ID#

General Provider Information

NPI Number	:	1982671871
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EVAN D SEHGAL MD

Provider Business Mailing Address
First Line	:	777 TERRACE AVE
Second Line	:	3RD FLOOR
City	:	HASBROUCK HEIGHTS
State	:	NJ
Zip	:	07604-3110
Country	:	US
Telephone Number	:	201-288-4252
Fax Number	:	201-288-7172

Provider Business Practice Location Address
First Line	:	777 TERRACE AVE
Second Line	:	3RD FLOOR
City	:	HASBROUCK HEIGHTS
State	:	NJ
Zip	:	07604-3110
Country	:	US
Telephone Number	:	201-288-4252
Fax Number	:	201-288-7172

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2006
Last Update Date	:	01/08/2015

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Directions to “ DR. EVAN D SEHGAL MD” Practice Location

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