Provider Demographics
NPI:1144285479
Name:SAGAR, PREM L (MD,FACP)
Entity type:Individual
Prefix:DR
First Name:PREM
Middle Name:L
Last Name:SAGAR
Suffix:
Gender:F
Credentials:MD,FACP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:141 MELANIE DR
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-1436
Mailing Address - Country:US
Mailing Address - Phone:516-735-5522
Mailing Address - Fax:516-644-5385
Practice Address - Street 1:4250 HEMPSTEAD TPKE
Practice Address - Street 2:SUITE 17
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-5711
Practice Address - Country:US
Practice Address - Phone:516-735-5522
Practice Address - Fax:516-644-5385
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY210715207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY210715OtherHIP/VYTRA
NYP00157993OtherRAILROAD MEDICARE
NY01919259Medicaid
NYP3090618OtherOXFORD
NYSP0715OtherATLANTIS
NY2590818OtherGHI PPO
NY295AB1OtherEMPIRE BCBS OF NY
NY3C9671OtherHEALTHNET
NY179120OtherELDER PLAN
NY3394510OtherAETNA HMO
NY7475519OtherAETNA PPO
NY900125879OtherTAX ID #
NY3394510OtherAETNA HMO
NY7475519OtherAETNA PPO