1851388953 NPI number — SHALINI G SEHGAL M.D.

Table of content: SHALINI G SEHGAL M.D. (NPI 1851388953)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851388953 NPI number — SHALINI G SEHGAL M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SEHGAL
Provider First Name:
SHALINI
Provider Middle Name:
G
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GROVER
Provider Other First Name:
SHALINI
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1851388953
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/17/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4923 OGLETOWN STANTON RD
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
NEWARK
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19713-2081
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-225-0451
Provider Business Mailing Address Fax Number:
302-225-0472

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
34434 KING STREET ROW
Provider Second Line Business Practice Location Address:
SUITE 4
Provider Business Practice Location Address City Name:
LEWES
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19958-4787
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-360-0142
Provider Business Practice Location Address Fax Number:
302-360-0145
Provider Enumeration Date:
10/04/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RN0300X , with the licence number:  C10007262 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1000033069 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".




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