Healthcare Provider Details

I. General information

NPI: 1689096307
Provider Name (Legal Business Name): RACHEL SEGAL MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2014
Last Update Date: 01/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 MATAWAN AVE APT A
CLIFFWOOD NJ
07721-1283
US

IV. Provider business mailing address

326 MATAWAN AVE APT A
CLIFFWOOD NJ
07721-1283
US

V. Phone/Fax

Practice location:
  • Phone: 732-970-7569
  • Fax:
Mailing address:
  • Phone: 732-970-7569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: