Healthcare Provider Details

I. General information

NPI: 1114915543
Provider Name (Legal Business Name): GEETA SEHGAL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 02/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

179 HIGH ST
NEWTON NJ
07860-1010
US

IV. Provider business mailing address

179 HIGH ST
NEWTON NJ
07860-1010
US

V. Phone/Fax

Practice location:
  • Phone: 973-383-4500
  • Fax: 973-383-8943
Mailing address:
  • Phone: 973-383-4500
  • Fax: 973-383-8943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMB07418100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: