Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | MA032152 | NJ |
NPI | 1497801740 |
---|---|
Provider Name | Dr. Gautam Sehgal |
First Address | South Orange, NJ 07079-2202 |
Second Address | South Orange, NJ 07079-2202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 08/07/2013 |