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General NPI Number Information
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NPI Number | 1912136227
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Entity Type | Individual
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Provider Name | SEJAL THAKOR MD
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Gender | Female
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Dates
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Enumeration Date | 07/08/2009
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 1215 BROADWAY
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City | RAYNHAM
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State | MA
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Zip | 02767-1942
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Country | US
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Telephone | 508-894-0400
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Fax | 508-941-6446
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Provider Business Mailing Address
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Address Line | 680 CENTRE ST
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City | BROCKTON
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State | MA
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Zip | 02302-3308
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Country | US
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Telephone | 508-894-0412
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Fax | 508-941-6446
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | E 7608
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 62820
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 1025416
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License Number State | MA
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