Healthcare Provider Details

I. General information

NPI: 1790097251
Provider Name (Legal Business Name): MARGARITA M. SERGONIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2010
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1631 15TH AVE W STE 103
SEATTLE WA
98119-2792
US

IV. Provider business mailing address

PO BOX 191
ROCKLAND DE
19732-0191
US

V. Phone/Fax

Practice location:
  • Phone: 206-752-5634
  • Fax:
Mailing address:
  • Phone:
  • Fax: 302-651-4945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD448793
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD448793
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: