Provider Demographics
NPI:1609371004
Name:ALAZAR, SENGAL KELIT (MD)
Entity type:Individual
Prefix:DR
First Name:SENGAL
Middle Name:KELIT
Last Name:ALAZAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SOUTHSIDE HOSPITAL EMERGENCY DEPARTMENT - NORTHWELL
Mailing Address - Street 2:301 EAST MAIN STREET
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706
Mailing Address - Country:US
Mailing Address - Phone:631-968-3970
Mailing Address - Fax:
Practice Address - Street 1:SOUTH SIDE HOSPITAL EMERGENCY DEPARTMENT - NORTHWELL
Practice Address - Street 2:301 EAST MAIN STREET
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706
Practice Address - Country:US
Practice Address - Phone:631-968-3970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD478282207P00000X
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine