Provider Demographics
NPI:1871551234
Name:SERGHANY, JOSEPH E (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:E
Last Name:SERGHANY
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:PO BOX 8000
Mailing Address - Street 2:DEPT 836
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14267
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:222 GENESEE ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203
Practice Address - Country:US
Practice Address - Phone:716-855-2866
Practice Address - Fax:716-855-2860
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY20163712085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
000524095014OtherBLUE SHIELD OF WESTERN NY
1609896OtherINDEPENDANT HEALTH
000524095010OtherBLUE SHIELD OF WESTERN NY
000524095015OtherBLUE SHIELD OF WESTERN NY
NY01625034Medicaid
P00003636OtherRAILROAD MEDICARE
00025092006OtherUNIVERA
300114647OtherRAILROAD MEDICARE
NYCRDRA20163OtherWORKERS COMPENSATION
P00346427OtherRAILROAD MEDICARE
145802FFOtherPREFERRED CARE
RB6947OtherRAILROAD MEDICARE
NYCRDRA20163OtherWORKERS COMPENSATION
000524095014OtherBLUE SHIELD OF WESTERN NY
000524095015OtherBLUE SHIELD OF WESTERN NY
145802FFOtherPREFERRED CARE