Provider Demographics
NPI:1154511335
Name:SAGALOVSKY, HELENA Z (MD)
Entity type:Individual
Prefix:
First Name:HELENA
Middle Name:Z
Last Name:SAGALOVSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 E 90TH DR
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-8102
Mailing Address - Country:US
Mailing Address - Phone:219-756-0937
Mailing Address - Fax:219-736-2013
Practice Address - Street 1:244 E 90TH DR
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-8102
Practice Address - Country:US
Practice Address - Phone:219-756-0937
Practice Address - Fax:219-736-2013
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01043789207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
INF63422Medicare UPIN
IN177330Medicare PIN