Healthcare Provider Details

I. General information

NPI: 1588893986
Provider Name (Legal Business Name): JEFFREY SEGAL MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2009
Last Update Date: 07/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94 OLD SHORT HILLS RD EAST WING, SUITE 401
LIVINGSTON NJ
07039-5672
US

IV. Provider business mailing address

94 OLD SHORT HILLS RD EAST WING, SUITE 401
LIVINGSTON NJ
07039-5672
US

V. Phone/Fax

Practice location:
  • Phone: 973-322-9998
  • Fax: 973-322-9790
Mailing address:
  • Phone: 973-322-9998
  • Fax: 973-322-9790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number25MA06957000
License Number StateNJ

VIII. Authorized Official

Name: JEFFREY L SEGAL
Title or Position: OWNER
Credential: MD
Phone: 973-322-9998