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Organization
SPS MEDICAL PC
Active
Organization
SPS MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PREM L SAGAR M.D. (OWNER)
(516) 735-5522
Entity
Organization
Contact information
Practice address
4250 HEMPSTEAD TPKE, SUIITE 19, BETHPAGE, NY 11714
(516) 735-5522
(516) 644-5385
Mailing address
141 MELANIE DR, EAST MEADOW, NY 11554-1436
(516) 735-5522
(516) 644-5385
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
210715
NY
207RN0300X
Nephrology Physician
202133
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01919259
—
NY
01
—
DC2627
RAILROAD MEDICARE GROUP
NY
Enumeration date
02/09/2007
Last updated
06/23/2008
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