Healthcare Provider Details

I. General information

NPI: 1356530539
Provider Name (Legal Business Name): SERGIO L. BAERGA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2007
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 WILLIAMSON ST FL 4
ELIZABETH NJ
07202-3625
US

IV. Provider business mailing address

379 CAMPUS DR FL 41
SOMERSET NJ
08873-1161
US

V. Phone/Fax

Practice location:
  • Phone: 908-994-5000
  • Fax:
Mailing address:
  • Phone: 732-937-8939
  • Fax: 324-188-3727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number246562
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number25MA09666400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: