Provider Demographics
NPI:1487987236
Name:SAYEGH, GREGORY J (DO)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:J
Last Name:SAYEGH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:790 NORTHERN BLVD
Mailing Address - Street 2:SUITE K
Mailing Address - City:SOUTH ABINGTON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18411-8799
Mailing Address - Country:US
Mailing Address - Phone:570-586-4141
Mailing Address - Fax:570-586-6722
Practice Address - Street 1:790 NORTHERN BLVD
Practice Address - Street 2:SUITE K
Practice Address - City:SOUTH ABINGTON TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18411-8799
Practice Address - Country:US
Practice Address - Phone:570-586-4141
Practice Address - Fax:570-586-6722
Is Sole Proprietor?:No
Enumeration Date:2009-09-11
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS016447207Q00000X
NJ25MB09026300207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1028499560001Medicaid
PA296334DOLMedicare PIN