Healthcare Provider Details

I. General information

NPI: 1538142666
Provider Name (Legal Business Name): CARLOS ALBERTO SAGEBIEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 06/15/2020
Certification Date: 06/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 WORLDS FAIR DR
SOMERSET NJ
08873-1369
US

IV. Provider business mailing address

2 WORLDS FAIR DR
SOMERSET NJ
08873-1369
US

V. Phone/Fax

Practice location:
  • Phone: 732-537-0909
  • Fax: 732-564-9032
Mailing address:
  • Phone: 732-537-0909
  • Fax: 732-564-9032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number25MA07139200
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number25MA07139200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: