Healthcare Provider Details

I. General information

NPI: 1215023924
Provider Name (Legal Business Name): MELIH SARIGUL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 06/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

296 CLIFTON AVE
CLIFTON NJ
07011
US

IV. Provider business mailing address

296 CLIFTON AVE
CLIFTON NJ
07011-2223
US

V. Phone/Fax

Practice location:
  • Phone: 973-249-8211
  • Fax: 973-249-8611
Mailing address:
  • Phone: 973-249-8211
  • Fax: 973-249-8611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number25MA06623700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: