1871551234 NPI number — JOSEPH E SERGHANY MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871551234 NPI number — JOSEPH E SERGHANY MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

SERGHANY

Provider First Name:

JOSEPH

Provider Middle Name:

E

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1871551234

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

05/19/2008

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 8000

Provider Second Line Business Mailing Address:

DEPT 836

Provider Business Mailing Address City Name:

BUFFALO

Provider Business Mailing Address State Name:

NY

Provider Business Mailing Address Postal Code:

14267

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

222 GENESEE ST

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

BUFFALO

Provider Business Practice Location Address State Name:

NY

Provider Business Practice Location Address Postal Code:

14203

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

716-855-2866

Provider Business Practice Location Address Fax Number:

716-855-2860

Provider Enumeration Date:

05/03/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 2085R0202X , with the licence number:  2016371 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 000524095014 . This is a "BLUE SHIELD OF WESTERN NY" identifier . This identifiers is of the category "OTHER".
• Identifier: 1609896 . This is a "INDEPENDANT HEALTH" identifier . This identifiers is of the category "OTHER".
• Identifier: 000524095010 . This is a "BLUE SHIELD OF WESTERN NY" identifier . This identifiers is of the category "OTHER".
• Identifier: 000524095015 . This is a "BLUE SHIELD OF WESTERN NY" identifier . This identifiers is of the category "OTHER".
• Identifier: 01625034 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
• Identifier: P00003636 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 00025092006 . This is a "UNIVERA" identifier . This identifiers is of the category "OTHER".
• Identifier: 300114647 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
• Identifier: CRDRA20163 . This is a "WORKERS COMPENSATION" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: P00346427 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 145802FF . This is a "PREFERRED CARE" identifier . This identifiers is of the category "OTHER".
• Identifier: RB6947 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".