Healthcare Provider Details

I. General information

NPI: 1063324887
Provider Name (Legal Business Name): JULIA ELIZABETH SEGAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9438 60TH AVE STE A3
ELMHURST NY
11373-5070
US

IV. Provider business mailing address

37 MADISON ST
HUNTINGTON NY
11743-2744
US

V. Phone/Fax

Practice location:
  • Phone: 718-896-5615
  • Fax:
Mailing address:
  • Phone: 631-379-3391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number132262-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: