Healthcare Provider Details

I. General information

NPI: 1083713374
Provider Name (Legal Business Name): ASHOK SEHGAL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 04/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 SHAKER RD SUITE 101
ALBANY NY
12204-1030
US

IV. Provider business mailing address

63 SHAKER RD SUITE 101
ALBANY NY
12204-1030
US

V. Phone/Fax

Practice location:
  • Phone: 518-434-1042
  • Fax: 518-434-4327
Mailing address:
  • Phone: 518-434-1042
  • Fax: 518-434-4327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number35-088411
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number246076
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: