Healthcare Provider Details

I. General information

NPI: 1003379801
Provider Name (Legal Business Name): VINAY SAGGAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2019
Last Update Date: 05/02/2023
Certification Date: 05/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 PELHAM PKWY S STE B125
BRONX NY
10461-1119
US

IV. Provider business mailing address

622 W 168TH ST STE 260
NEW YORK NY
10032-3720
US

V. Phone/Fax

Practice location:
  • Phone: 718-918-5820
  • Fax:
Mailing address:
  • Phone: 212-305-6059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number320659
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: