Basic Information
| Provider Information | |||||||||
| NPI: | 1023111564 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SAYEGH | ||||||||
| FirstName: | MARTIN | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 626 MCLEAN AVE | ||||||||
| Address2: | |||||||||
| City: | YONKERS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9144235000 | ||||||||
| FaxNumber: | 9149668003 | ||||||||
| Practice Location | |||||||||
| Address1: | 626 MCLEAN AVE | ||||||||
| Address2: | |||||||||
| City: | YONKERS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9144235000 | ||||||||
| FaxNumber: | 9149668003 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/07/2006 | ||||||||
| LastUpdateDate: | 10/26/2010 | ||||||||
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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 | 207Q00000X | 160165 | NY | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 00934029 | 05 | NY | MEDICAID |