Healthcare Provider Details

I. General information

NPI: 1134314404
Provider Name (Legal Business Name): BEATRICE SEGAL LCSW, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2007
Last Update Date: 09/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

184 FOREST AVE
PARAMUS NJ
07652-5326
US

IV. Provider business mailing address

184 FOREST AVE
PARAMUS NJ
07652-5326
US

V. Phone/Fax

Practice location:
  • Phone: 201-265-3310
  • Fax: 201-265-8219
Mailing address:
  • Phone: 201-265-3310
  • Fax: 201-265-8219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC00488200
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNC17357
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: