Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QG0300X | Family Doctor - Geriatric Medicine | 35084673 | OH |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | ME125594 | FL |
NPI | 1215913728 |
---|---|
Provider Name | Mandi Sehgal |
First Address | Boca Raton, FL 33431 |
Second Address | Weston, FL 33331-3609 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2005 |
Last Update Date | 06/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I03496 | (02) |