MEDICARE: DR. VISHAL SAGGAR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	299135	NY

General Provider Information

NPI Number	:	1225419047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VISHAL SAGGAR M.D.

Provider Business Mailing Address
First Line	:	400 N BROADWAY
Second Line	:
City	:	JERICHO
State	:	NY
Zip	:	11753-2113
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 N BROADWAY
Second Line	:
City	:	JERICHO
State	:	NY
Zip	:	11753-2113
Country	:	US
Telephone Number	:	516-992-6350
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2015
Last Update Date	:	07/05/2019

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