Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 059195-1 | NY |
NPI | 1013396746 |
---|---|
Provider Name | Dr. Mary Sayegh |
First Address | Little Falls, NJ 07424-2361 |
Second Address | Bronx, NY 10467-2401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2015 |
Last Update Date | 14/12/2021 |