Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 25MB08902400 | NJ |
N | 207Q00000X | Family Doctor | C7-0003788 | DE |
Y | 207QS0010X | Family Doctor - Sports Medicine | 25MB08902400 | NJ |
NPI | 1073717468 |
---|---|
Provider Name | Dr. Thomas G Sargent JR. |
First Address | Brick, NJ 08724-7776 |
Second Address | Brick, NJ 08724-7776 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2007 |
Last Update Date | 28/01/2021 |