Basic Information
| Provider Information | |||||||||
| NPI: | 1356341101 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SAYEGH | ||||||||
| FirstName: | HENRI | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 66 POWERHOUSE RD | ||||||||
| Address2: | 3RD FLOOR | ||||||||
| City: | ROSLYN HEIGHTS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115771324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166266366 | ||||||||
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| Practice Location | |||||||||
| Address1: | 300 COMMUNITY DR | ||||||||
| Address2: | ANESTHESIA DEPARTMENT | ||||||||
| City: | MANHASSET | ||||||||
| State: | NY | ||||||||
| PostalCode: | 110303816 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5165624887 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 130966 | NY | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 00275030 | 05 | NY | MEDICAID |